Kyphoplasty and Vertebroplasty Produce the Same Degree of Height Restoration

Overview

Journal AJNR Am J Neuroradiol

Specialty Neurology

Date 2009 Jan 10

PMID 19131409

Citations 34

Authors

A Hiwatashi

P-L A Westesson

T Yoshiura

T Noguchi

O Togao

K Yamashita

H Kamano

H Honda

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: There are few comparative studies regarding morphologic changes after kyphoplasty and vertebroplasty. The purpose of this study was to compare restoration of vertebral body height and wedge angle and cement leakage with kyphoplasty and vertebroplasty in osteoporotic compression fractures.

Materials And Methods: Forty patients (57 vertebrae) were treated with kyphoplasty, and 66 patients (124 vertebrae) were treated with vertebroplasty. Cement leakage into the disk space and paravertebral soft tissues or veins was analyzed on immediate postoperative CT scans. The height and wedge angle were measured before and after treatment and analyzed with the Mann-Whitney U test and chi(2) test.

Results: Kyphoplasty and vertebroplasty both improved vertebral body height and the wedge angles (P < .05). However, these differences were not statistically significant when the 2 techniques were compared (P > .05). There were 18% of the kyphoplasty group and 49% of the vertebroplasty group that showed cement leakage into the paravertebral soft tissues or veins (P < .01). Cement leakage into the disk space occurred in 12% of the kyphoplasty group and in 25% of the vertebroplasty group (P < .01). However, no complications related to cement leakage were noted.

Conclusions: Both kyphoplasty and vertebroplasty achieved the same degree of height restoration and improvement of the wedge angle. Kyphoplasty resulted in less cement leakage into the disk space and paravertebral soft tissues or veins than vertebroplasty.

Citing Articles

Outcomes of percutaneous vertebroplasty in multiple myeloma: a tertiary neurosciences experience with long-term follow-up.

Holmes H, Balian V, Kular S, Batty R, Connolly D, Chantry A Front Oncol. 2024; 14:1291055.

PMID: 38665945 PMC: 11044180. DOI: 10.3389/fonc.2024.1291055.

Anterior thoracolumbar column reconstruction with the vertebral body stent-safety and efficacy.

Oswald K, Kalin J, Tinner C, Deml M, Bigdon S, Hoppe S Eur Spine J. 2023; 32(3):934-949.

PMID: 36715755 DOI: 10.1007/s00586-023-07537-3.

Vertebral Body Height Changes in Acute Symptomatic Osteoporotic Vertebral Compression Fractures Treated with Vertebral Cement Augmentation-Which Factors Affect Vertebral Body Height during Follow-up? A Multiple Linear Regression Study.

Payo-Ollero J, Llombart-Blanco R, Villas C, Alfonso M Geriatrics (Basel). 2022; 7(6).

PMID: 36547278 PMC: 9777838. DOI: 10.3390/geriatrics7060142.

The Value of Dynamic Fracture Mobility in Determining the Optimum Operation Choice for Acute Osteoporotic Vertebral Compression Fracture.

Ren H, Feng T, Hu Y, Yao G, Yu D, Cao J J Pain Res. 2022; 15:2327-2336.

PMID: 35992249 PMC: 9386056. DOI: 10.2147/JPR.S368493.

Percutaneous Kyphoplasty in Patients with Severe Osteoporotic Vertebral Compression Fracture with and without Intravertebral Cleft: A Retrospective Comparative Study.

Liu H, Zhou Q, Shao X, Zhang J, Deng L, Liu T Int J Gen Med. 2022; 15:6199-6209.

PMID: 35880137 PMC: 9307916. DOI: 10.2147/IJGM.S369840.

References

Rhyne 3rd A, Banit D, Laxer E, Odum S, Nussman D . Kyphoplasty: report of eighty-two thoracolumbar osteoporotic vertebral fractures. J Orthop Trauma. 2004; 18(5):294-9. DOI: 10.1097/00005131-200405000-00005. View

Zoarski G, Snow P, Olan W, Stallmeyer M, Dick B, Hebel J . Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. J Vasc Interv Radiol. 2002; 13(2 Pt 1):139-48. DOI: 10.1016/s1051-0443(07)61930-7. View

Dublin A, Hartman J, Latchaw R, Hald J, Reid M . The vertebral body fracture in osteoporosis: restoration of height using percutaneous vertebroplasty. AJNR Am J Neuroradiol. 2005; 26(3):489-92. PMC: 7976481. View

Wong W, Mathis J . Vertebroplasty and kyphoplasty: techniques for avoiding complications and pitfalls. Neurosurg Focus. 2005; 18(3):e2. DOI: 10.3171/foc.2005.18.3.3. View

Layton K, Thielen K, Koch C, Luetmer P, Lane J, Wald J . Vertebroplasty, first 1000 levels of a single center: evaluation of the outcomes and complications. AJNR Am J Neuroradiol. 2007; 28(4):683-9. PMC: 7977361. View

Jensen M, Evans A, Mathis J, Kallmes D, Cloft H, Dion J . Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol. 1997; 18(10):1897-904. PMC: 8337380. View

McGraw J, Cardella J, Barr J, Mathis J, Sanchez O, Schwartzberg M . Society of Interventional Radiology quality improvement guidelines for percutaneous vertebroplasty. J Vasc Interv Radiol. 2003; 14(9 Pt 2):S311-5. DOI: 10.1097/01.rvi.0000082822.75926.4c. View

Voggenreiter G . Balloon kyphoplasty is effective in deformity correction of osteoporotic vertebral compression fractures. Spine (Phila Pa 1976). 2005; 30(24):2806-12. DOI: 10.1097/01.brs.0000190885.85675.a0. View

Wilhelm K, Stoffel M, Ringel F, Rao G, Rosseler L, Urbach H . [Preliminary experience with balloon kyphoplasty for the treatment of painful osteoporotic compression fractures]. Rofo. 2003; 175(12):1690-6. DOI: 10.1055/s-2003-45339. View

10.

Hiwatashi A, Moritani T, Numaguchi Y, Westesson P . Increase in vertebral body height after vertebroplasty. AJNR Am J Neuroradiol. 2003; 24(2):185-9. PMC: 7974119. View

11.

Laredo J, Hamze B . Complications of percutaneous vertebroplasty and their prevention. Skeletal Radiol. 2004; 33(9):493-505. DOI: 10.1007/s00256-004-0776-8. View

12.

Shindle M, Gardner M, Koob J, Bukata S, Cabin J, Lane J . Vertebral height restoration in osteoporotic compression fractures: kyphoplasty balloon tamp is superior to postural correction alone. Osteoporos Int. 2006; 17(12):1815-9. DOI: 10.1007/s00198-006-0195-x. View

13.

Eck J, Nachtigall D, Humphreys S, Hodges S . Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature. Spine J. 2007; 8(3):488-97. DOI: 10.1016/j.spinee.2007.04.004. View

14.

Hulme P, Krebs J, Ferguson S, Berlemann U . Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine (Phila Pa 1976). 2006; 31(17):1983-2001. DOI: 10.1097/01.brs.0000229254.89952.6b. View

15.

Grohs J, Matzner M, Trieb K, Krepler P . Minimal invasive stabilization of osteoporotic vertebral fractures: a prospective nonrandomized comparison of vertebroplasty and balloon kyphoplasty. J Spinal Disord Tech. 2005; 18(3):238-42. View

16.

Pradhan B, Bae H, Kropf M, Patel V, Delamarter R . Kyphoplasty reduction of osteoporotic vertebral compression fractures: correction of local kyphosis versus overall sagittal alignment. Spine (Phila Pa 1976). 2006; 31(4):435-41. DOI: 10.1097/01.brs.0000200036.08679.1e. View

17.

Lin E, Ekholm S, Hiwatashi A, Westesson P . Vertebroplasty: cement leakage into the disc increases the risk of new fracture of adjacent vertebral body. AJNR Am J Neuroradiol. 2004; 25(2):175-80. PMC: 7974625. View

18.

Syed M, Patel N, Jan S, Harron M, Morar K, Shaikh A . Intradiskal extravasation with low-volume cement filling in percutaneous vertebroplasty. AJNR Am J Neuroradiol. 2005; 26(9):2397-401. PMC: 7976146. View

19.

Komemushi A, Tanigawa N, Kariya S, Kojima H, Shomura Y, Komemushi S . Percutaneous vertebroplasty for osteoporotic compression fracture: multivariate study of predictors of new vertebral body fracture. Cardiovasc Intervent Radiol. 2006; 29(4):580-5. DOI: 10.1007/s00270-005-0138-5. View

20.

McKiernan F, Jensen R, Faciszewski T . The dynamic mobility of vertebral compression fractures. J Bone Miner Res. 2003; 18(1):24-9. DOI: 10.1359/jbmr.2003.18.1.24. View