Current status of percutaneous vertebroplasty and percutaneous kyphoplasty – a review

Abstract

Percutaneous vertebroplasty (PV) and kyphoplasty (PK) are the 2 vertebral augmentation procedures that have emerged as minimally invasive surgical options to treat painful vertebral compression fractures (VCF) during the last 2 decades. VCF may either be osteoporotic or tumor-associated. Two hundred million women are affected by osteoporosis globally. Vertebral fracture may result in acute pain around the fracture site, loss of vertebral height due to vertebral collapse, spinal instability, and kyphotic deformity. The main goal of the PV and PK procedures is to give immediate pain relief to patients and restore the vertebral height lost due to fracture. In percutaneous vertebroplasty, bone cement is injected through a minimal incision into the fractured site. Kyphoplasty involves insertion of a balloon into the fractured site, followed by inflation-deflation to create a cavity into which the filler material is injected, and the balloon is taken out prior to cement injection. This literature review presents a qualitative overview on the current status of vertebral augmentation procedures, especially PV and PK, and compares the efficacy and safety of these 2 procedures. The review consists of a brief history of the development of these 2 techniques, a discussion on the current research on the bone cement, clinical outcome of the 2 procedures, and it also sheds light on ongoing and future research to maximize the efficacy and safety of vertebral augmentation procedures.

Percutaneous stabilization of lumbar spine: a literature review and new options in treating spine pain

“…50,51 Bioactive composite materials prepared from acrylic cement in conjunction with ceramics showed good radioopacity. 52 Cortoss, a composed material-based bone cement currently undergoing clinical trials for PVP and BKP is composed of terpolymer resin with combeite glass-ceramics.…”

Percutaneous vertebroplasty guided by preoperative computed tomography measurements

“…Vertebroplasty and kyphoplasty are the most routinely used minimally invasive procedures to treat VCF during last two decades 8. Clinical studies have reported no difference in the outcome of pain relief and quality of life improvement between PVP and penetrating keratoplasty (PKP) 910.…”

Oligometastatic Breast Cancer: A Shift from Palliative to Potentially Curative Treatment?

“…In PK, a balloon is inserted into the fractured site and inflated-deflated to create a cavity: the balloon is then taken out prior to cement injection. Both procedures are superior to oral pain management: no direct comparison is available but systematic reviews of the existing data showed very little difference in clinical outcomes of the 2 techniques [73]. The overall rate of complications associated with PV and PK is low, but the rate of cement extravasation is higher in PV.…”

“…The overall rate of complications associated with PV and PK is low, but the rate of cement extravasation is higher in PV. PV of painful osteolytic spinal metastases from BC is safe even in the case of substantial involvement of the vertebral cross-sectional area or cortical bone [73,74]. To establish the relative strengths and weaknesses of all these procedures, well-designed randomized clinical trials are required.…”