Comparison of effectiveness of kyphoplasty and vertebroplasty in patients with osteoporotic vertebra fractures

Abstract

ObjectiveThe aim of this study was to compare the functional and radiological outcomes of vertebroplasty and kyphoplasty in patients with osteoporotic vertebra fractures.MethodsThe files of the patients who underwent vertebroplasty or kyphoplasty for osteoporotic vertebrae fractures were retrieved from the archives. Forty-three patients with complete follow-up data were included in the study group. The patients were evaluated for radiological outcomes in terms of local kyphosis angle, wedging index, compression ratio, visual analog pain scale (VAS) and Oswestry Disability Index (ODI).ResultsIn the study group, kyphoplasty was performed on 24 vertebrae of 22 patients (17 females, 5 males; mean age: 73 years) whereas vertebroplasty was applied on 24 vertebrae of 21 (16 females, 5 males; mean age: 74.7 years) patients. The mean follow-up time was 26 months. When the VAS and ODI values of the groups were analyzed, both groups showed statistically significant progress after the operation. Radiological data showed that the kyphoplasty group showed statistically significant improvement in the sagittal index values whereas the vertebroplasty group did not. The overall complication ratio was 4%.ConclusionBoth vertebroplasty and kyphoplasty are effective treatment methods for functional recovery and pain relief in osteoporotic fractures of the vertebra. Although radiological outcomes of the kyphoplasty seem to be better, this does not have any clinical relevance. We suggest vertebroplasty over kyphoplasty since it is an easier method to manage.Level of evidenceLevel III, Therapeutic study.

Posttraumatic Delayed Vertebral Collapse : Kummell’s Disease

“…VP and KP can be considered when pain remains or progressive vertebral collapse occurs even after conservative treatments are performed. VP and KP for OVCF are all effective, while KP is effective for reduction of vertebral body height, but there is no significant difference in pain control between VP and KP 3 , 5) . Some reported that when an IVC sign is present, polymethyl methacrylate (PMMA) is not an appropriate scaffolding for the fractured vertebral body as PMMA cannot be interdigitated with the trabeculae of the vertebral body, because the fibrocartilaginous membrane is formed inside the IVC, resulting in vertebral compression fracture, which makes intravertebral PMMA be dislodged to the spinal canal, possibly causing neurologic compromise 18) .…”

“…It is known that the difference in the effectiveness of VP and KP is not significant, and the correction of kyphotic angle is better in KP than VP, without much significance 3 , 5) . It was suggested that it is important to fully fill the cavity using sufficient PMMA by increasing the size of IVC and restoring vertebral body height with the inducement of hyperlordosis during surgery, and it is meaningful to use a cavitogram to check the process 13) .…”

“… 18) . As indicated by these confusing names, there is no known guideline for the accurate pathogenesis, radiological diagnosis methods and the best treatments for this disease until now 3 , 7 , 18 , 25 , 37) .…”

Influence of the distribution of bone cement along the fracture line on the curative effect of vertebral augmentation

“…5–7 Surgical treatments include percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP). 8–10 The bone cement distribution in vertebral augmentation is related to the treatment effect, 11–13 but the influence of the type of distribution of bone cement along the fracture line on the curative effect is rarely reported. Therefore, the present study focused on the effects of different types of bone cement distribution along the fracture line on pain relief, bone cement leakage, recovery from vertebral compression, and other parameters in patients with OVCFs.…”

Percutaneous Balloon Kyphoplasty Vertebral Augmentation for Compression Fracture Due to Vertebral Metastasis: A 12-Month Retrospective Clinical Study in 72 Patients

“…The local kyphosis angle (KA) was 15.3±11.4 before the procedure and 8.02±2.9 after the procedure (P<0.005). In previously published studies, restoration of VHR with kyphoplasty was reported to be 12.8–31.7% and the KA correlation was 3.9–16.5° [ 11 – 13 ]. In these previous studies, the lowest KA cure rate was reported in patients with rheumatoid arthritis [ 14 ].…”