Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review

Bouza, Carmen; López, Teresa; Magro, Angeles; Navalpotro, Lourdes; Amate, José Marı́a

doi:10.1007/s00586-005-0048-x

Cited by 186 publications

(133 citation statements)

References 53 publications

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“…There is class I evidence to support the superiority of vertebral augmentation procedures (VAPs) over NSM [8][9][10], as well as non-randomized prospective studies [11][12][13], systematic reviews [14][15][16][17][18][19], and numerous retrospective series supporting safety and effectiveness of these procedures. However, recently published randomized controlled trials (RCTs) that showed no superiority of VP over NSM [20] or over a simulated procedure (sham) [21,22] have raised questions regarding the value of VP.…”

Section: Introductionmentioning

confidence: 99%

Comparing effects of kyphoplasty, vertebroplasty, and non-surgical management in a systematic review of randomized and non-randomized controlled studies

et al. 2012

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Purpose To determine if differences in safety or efficacy exist between balloon kyphoplasty (BKP), vertebroplasty (VP) and non-surgical management (NSM) for the treatment of osteoporotic vertebral compression fractures (VCFs). Methods As of February 1, 2011, a PubMed search (key words: kyphoplasty, vertebroplasty) resulted in 1,587 articles out of which 27 met basic selection criteria (prospective multiple-arm studies with cohorts of C20 patients).This systematic review adheres to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines.Results Pain reduction in both BKP (-5.07/10 points, P \ 0.01) and VP (-4.55/10, P \ 0.01) was superior to that for NSM (-2.17/10), while no difference was found between BKP/VP (P = 0.35). Subsequent fractures occurred more frequently in the NSM group (22 %) compared with VP (11 %, P = 0.04) and BKP (11 %, P = 0.01). BKP resulted in greater kyphosis reduction than VP (4.88 vs. 1.7°, P \ 0.01). Quality of life (QOL) improvement showed superiority of BKP over VP (P = 0.04), along with a trend for disability improvement (P = 0.08). Cement extravasation was less frequent in the BKP (P = 0.01). Surgical intervention within the first 7 weeks yielded greater pain reduction than VCFs treated later. Conclusions BKP/VP provided greater pain relief and fewer subsequent fractures than NSM in osteoporotic VCFs. BKP is marginally favored over VP in disability improvement, and significantly favored in QOL improvement. BKP had a lower risk of cement extravasation and resulted in greater kyphosis correction. Despite this analysis being restricted to Level I and II studies, significant heterogeneity suggests that the current literature is delivering inconsistent messages and further trials are needed to delineate confounding variables.

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Section: Introductionmentioning

confidence: 99%

Comparing effects of kyphoplasty, vertebroplasty, and non-surgical management in a systematic review of randomized and non-randomized controlled studies

et al. 2012

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“…It has several advantages, such as reduction of the fracture, restoration of vertebral height, relief of pain, and reduced chance of cement leakage. Numerous authors have reported the advantages of PKP and satisfactory clinical results after the procedure [3,4,8,9,20,21,28,29].…”

Section: Introductionmentioning

confidence: 99%

Recompression of vertebral body after balloon kyphoplasty for osteoporotic vertebral compression fracture

2010

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The purpose of this retrospective clinical study was to evaluate the factors that affect recompression of operated vertebrae after percutaneous balloon kyphoplasty (PKP) for osteoporotic vertebral compression fractures (VCFs) and assess their clinical importance. PKP has been used for VCFs with satisfactory results. Several studies about subsequent VCFs adjacent to cemented vertebrae have been reported after PKP. However, the presence and significance of recompression of operated vertebrae have not been adequately described. In total, 80 patients treated with PKP for single thoracolumbar VCFs were reviewed. The follow-up period was at least 1 year. Patients were divided into those without recompression (maintained group, n = 70) and those with recompression (recompressed group, n = 10). Plain roentgenography (preoperative, operative, and last), preoperative BMD, and preoperative MRI were checked. Age, gender, T-score in BMD, duration of symptom, compression rate (CR) of VCF, reduction rate, kyphotic angle (KA), reduction angle, intervertebral cleft (IVC), and non-PMMA-endplate-contact (NPEC) were evaluated. To evaluate the clinical results, we checked the VAS score at each follow-up period. All data were analyzed statistically. The CR for the recompressed group increased significantly after surgery and decreased at the last follow-up (p \ 0.05). The last CR was not significantly different from the preoperative CR. The KA showed the same pattern. The preoperative, postoperative, and last VAS scores were significantly different from one another in both groups (p \ 0.05). Between the groups, preoperative KA, postoperative KA, last KA, IVC, and NPEC were significantly different (p \ 0.05). In particular, last KA, IVC, and NPEC showed highly significant differences (p \ 0.001). In a correlation test for the evaluated factors, IVC (r = 0.557) and NPEC (r = 0.496) were the most significant. The presence of IVC and NPEC may play an important role in inducing recompression of treated vertebrae after PKP. Careful observation of patients with these conditions is necessary to prevent deterioration of their clinical course.

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“…Though polymethylmethacrylate (PMMA) vertebroplasty or kyphoplasty has been reported to treat VCFs with good clinical results [10,12,19,28,43] and correction of deformity [5,29,44], some complications have been reported [3,4,11,14,27,39,41] which cannot be completely avoided. Cement extravasation in vertebroplasty is the most frequent problem, which has been reported in 38% [49] to 72.5% [11] malignant VCFs and 30% [23] to 65% [10] of osteoporotic VCFs.…”

Section: Introductionmentioning

confidence: 99%

Transpedicle body augmenter in painful osteoporotic compression fractures

Hsieh

et al. 2006

Eur Spine J

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Osteoporotic compression fractures (VCFs) can result in progressive kyphosis and chronic pain. Polymethylmethacrylate has been used for augmentation of VCFs; however, there are cement complications, and long-term fracture healing is unknown. The transpedicle body augmenter (TpBA), a porous titanium spacer, has been reported as an internal support to reconstruct the vertebral body combining short segment fixation in burst fracture. We retrospectively reviewed radiographic and clinical results of TpBA vertebroplasty for single symptomatic VCF in 80 patients. Manual reduction and TpBA vertebroplasty via a paramedian incision with blunt dissection was done. Mean age was 72.3 years (range 51-87 years), and female-male ratio was 66:14. The mean symptom duration was 5 months, and follow-up 44 months. Peri-operative variables and radiographic and clinical results were evaluated. The average operation time was 26

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Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review

Cited by 186 publications

References 53 publications

Comparing effects of kyphoplasty, vertebroplasty, and non-surgical management in a systematic review of randomized and non-randomized controlled studies

Comparing effects of kyphoplasty, vertebroplasty, and non-surgical management in a systematic review of randomized and non-randomized controlled studies

Recompression of vertebral body after balloon kyphoplasty for osteoporotic vertebral compression fracture

Transpedicle body augmenter in painful osteoporotic compression fractures

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