Is kyphoplasty better than vertebroplasty at restoring form and function after severe vertebral wedge fractures?

Landham, Priyan R.; Baker-Rand, Holly L. A.; Gilbert, S; Pollintine, P; Annesley-Williams, Deborah J.; Adams, Michael A.; Dolan, Patricia

doi:10.1016/j.spinee.2014.11.017

Cited by 35 publications

(29 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Explanation of results Vertebral fracture damages the endplate, allowing it to bulge more into the vertebral body under load (Brinckmann et al, 1983). This decompresses the adjacent disc nucleus (Dolan et al, 2013) and transfers compressive load-bearing on to the annulus fibrosus (Stefanakis et al, 2014) and neural arch (Pollintine et al, 2004b;Landham et al, 2015a). Subsequent loading can then be concentrated on to the anterior vertebral body cortex to such an extent that it causes anterior (Landham et al 2015b).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Vertebroplasty reduces progressive ׳creep’ deformity of fractured vertebrae

Luo

Pollintine

Annesley-Williams

et al. 2016

Journal of Biomechanics

View full text Add to dashboard Cite

Elderly vertebrae frequently develop an "anterior wedge" deformity as a result of fracture and creep mechanisms. Injecting cement into a damaged vertebral body (vertebroplasty) is known to help restore its shape and stiffness. We now hypothesise that vertebroplasty is also effective in reducing subsequent creep deformations. Twenty-eight spine specimens, comprising three complete vertebrae and the intervening discs, were obtained from cadavers aged 67-92 years. Each specimen was subjected to increasingly-severe compressive loading until one of its vertebrae was fractured, and the damaged vertebral body was then treated by vertebroplasty. Before and after fracture, and again after vertebroplasty, each specimen was subjected to a static compressive force of 1kN for 1h while elastic and creep deformations were measured in the anterior, middle and posterior regions of each adjacent vertebral body cortex, using a 2D MacReflex optical tracking system. After fracture, creep in the anterior and central regions of the vertebral body cortex increased from an average 4513 and 885 microstrains, respectively, to 54,107 and 34,378 microstrains (both increases: P<0.001). Elastic strains increased by a comparable amount. Vertebroplasty reduced creep in the anterior and central cortex by 61% (P=0.006) and 66% (P=0.017) respectively. Elastic strains were reduced by less than half this amount. Results suggest that the beneficial effects of vertebroplasty on the vertebral body continue long after the post-operative radiographs. Injected cement not only helps to restore vertebral shape and elastic properties, but also reduces subsequent creep deformation of the damaged vertebra.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Injecting cement into an affected vertebra, using the techniques of vertebroplasty or kyphoplasty (Garfin et al, 2001), increases vertebral compressive stiffness and strength (Belkoff et al, 1999) (Luo et al, 2007). It can help to reverse the anterior wedge deformity also (Landham et al, 2015a).…”

Section: Introductionmentioning

confidence: 99%

Vertebroplasty reduces progressive ׳creep’ deformity of fractured vertebrae

Luo

Pollintine

Annesley-Williams

et al. 2016

Journal of Biomechanics

View full text Add to dashboard Cite

show abstract

“…The cases after PKP were particularly serious, which might be the result of different contact between bone cement surfaces in PKP balloons. There are many reasons for vertebral height loss after vertebral augmentation, for example, the severity of osteoporosis, the choice of surgical methods, the different surgical approaches, the different degrees of preoperative vertebral compression, the different distributions of bone cement, the different amounts of bone cement injection, or the existence of intravertebral cleft and other reasons [16][17][18][19][20][21][22][23]. Therefore, vertebroplasty alone is not appropriate for the treatment of OVF with severe compression and kyphosis.…”

Section: Compared With Previous Studiesmentioning

confidence: 99%

Efficacy analysis of percutaneous pedicle screw fixation combined with percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures with kyphosis

Wang

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

Background: To investigate the clinical effect of percutaneous pedicle screw fixation (PPSF) combined with percutaneous vertebroplasty (PVP) in the treatment of osteoporotic compression vertebral fracture (OVCF) of the thoracolumbar vertebra with kyphosis. Methods: One hundred sixty-six patients before June 2017 were retrospectively analyzed, and patients were divided into PPSF + PVP group A and PVP group B. Operative time, bone mineral density, postoperative bed time, high compression ratio, bone cement leakage rate, and bone cement dose were recorded. Comparison of vertebral anterior edge height, Cobb angle, visual analogue score (VAS), and low back pain dysfunction index (ODI) between the two groups in preoperative, postoperative 3 days, postoperative 6 months, postoperative 12 months, and postoperative 24 months, postoperative complications were observed in the two groups. Results: The operation time of group A was longer than that of group B (59.0 ± 8.6 min, 26.6 ± 5.2 min), longer postoperative bed rest time (3.3 ± 0.7 days, 1.2 ± 0.5 days), the differences were statistically significant (P < 0.01), there was no difference in the amount of bone cement between the two groups (5.4 ± 0.6 ml, 5.3 ± 0.8 ml) (P > 0.05). The height of the anterior edge and Cobb angle of the two groups recovered significantly in postoperative 3 days. The height of anterior edge (2.7 ± 0.

show abstract

“…Osteoporotic vertebral compression fractures (OVCFs) are one of the most common complications of osteoporosis in the elderly population, which cause severe back pain, restrict activity, and lower the quality of life. 1 – 3 The minimally invasive techniques such as percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) were introduced to reduce these clinical problems other than traditional methods such as conservative treatment or open surgery. 4 – 6 PVP, which has been recognized as an effective procedure in the treatment of OVCFs, does not have the advantage of reduction of the sagittal alignment of the spine compared to PKP.…”

Section: Introductionmentioning

confidence: 99%

Which one is more effective for the treatment of very severe osteoporotic vertebral compression fractures: PVP or PKP?

Wang¹,

Wang²,

Miao³

et al. 2018

JPR

View full text Add to dashboard Cite

PurposeThe purpose of this study was to compare the clinical efficacy and safety of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of the elderly with very severe osteoporotic vertebral compression fractures (vsOVCFs).MethodsFrom September 2012 to September 2015, 57 patients with vsOVCFs who had undergone PVP and PKP surgeries at our medical center were reviewed retrospectively, at least 2 years follow-up. All patients were divided into PVP group (n=31) and PKP group (n=26). Clinical data including clinical and radiological evaluation results were performed pre- and postoperatively.ResultsThe operation time of PVP group (29.6±3.3 minutes) was less than that of PKP group (37.4±4.2 minutes), with significant differences (P<0.05). Compared with preoperative data, the VAS scores, Oswestry disability index (ODI) scores, and local kyphotic angle were improved with significant differences at 1 day after surgery and the last follow-up in two groups (P<0.05). However, there were no differences in VAS and ODI scores between the two groups (P>0.05). The local kyphotic angle of PVP group was more than that of PKP group after surgery, with significant differences (P<0.05). At 1 day after surgery and the last follow-up, the anterior height of vertebrae fractured was significantly improved compared with preoperative in PKP group (P<0.05), and there was no statistical difference compared with preoperative in PVP group (P>0.05). However, there were no significant differences between the two groups in the leakage rate of bone cement (P>0.05) and incidence of adjacent-level vertebra fracture (P>0.05).ConclusionBoth PVP and PKP can significantly relieve the pain of the patients with vsOVCFs. Restoring the vertebral height and local kyphotic angle corrections of PKP are comparatively better than those of PVP. However, the operation time of PKP is significantly longer than that of PVP and PKP is not superior in the leakage rate of bone cement and incidence of adjacent-level vertebra fracture compared to PVP.

show abstract

Is kyphoplasty better than vertebroplasty at restoring form and function after severe vertebral wedge fractures?

Cited by 35 publications

References 55 publications

Vertebroplasty reduces progressive ׳creep’ deformity of fractured vertebrae

Vertebroplasty reduces progressive ׳creep’ deformity of fractured vertebrae

Efficacy analysis of percutaneous pedicle screw fixation combined with percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures with kyphosis

Which one is more effective for the treatment of very severe osteoporotic vertebral compression fractures: PVP or PKP?

Contact Info

Product

Resources

About