Vertebroplasty and kyphoplasty: complementary tecniques for the treatment of painful osteoporotic vertebral compression fractures

Abstract

OBJECTIVE: in a prospective study, we aimed to evaluate the potential use of kyphoplasty (KP) and vertebroplasty (VP) as complementary techniques in the treatment of painful osteoporotic vertebral compression fractures (VCFs). METHODS: after one month of conservative treatment for VCFs, patients with intractable pain were offered treatment with KP or VP according to a treatment algorithm that considers time from fracture (Ät) and amount of Vertebral Body Collapse (VBC). Bone biopsy was obtained intraoperatively to exclude patients affected by malignancy or osteomalacia. RESULTS: hundred and sixty-four patients were included according to the above criteria. Mean age was 67.6 years. Mean followup was 33 months. Ten patients (6.1%) were lost to follow-up and 154 reached the minimum two years follow-up. 118 (69.5%) underwent VP and 36 (30.5%) underwent KP. Complications affected five patients treated with VP, whose one suffered a transient intercostal neuropathy and four a subsequent VCF (two at adjacent level). Results in terms of VAS and Oswestry scores were not different among treatment groups. CONCLUSION: in conclusion, at an average follow-up of almost 3 years from surgical treatment of osteoporotic VCFs, VP and KP show similar good clinical outcomes and appear to be complementary techniques with specific different indications.

Avaliação clínica e radiográfica da cifoplastia no tratamento das fraturas vertebrais por osteoporose

“…A cifoplastia é uma evolução da técnica da vertebroplastia por possuir uma etapa inicial que consiste em insuflar um balão dentro do corpo vertebral, criando uma cavidade para o preenchimento do cimento 9 . Isso proporcionaria maior segurança, pois o cimento é injetado sob baixa pressão e permite redução da fratura e melhora da deformidade no plano sagital 2 .…”

The Michel Benoist and Robert Mulholland yearly European Spine Journal Review: a survey of the “medical” articles in the European Spine Journal, 2009

“…An interesting prospective study has been performed by Lovi et al [14], presented in the June supplement, to evaluate and compare efficacy and safety of vertebroplasty (VP) and kyphoplasty (KP) in the treatment of osteoporotic vertebral fractures (OVF). In a consecutive series of 164 patients, one of the two treatments (VP or KP) was offered to the patient after 1 month of failed conservative therapy according to an algorithm designed by the authors, taking into account time from fracture and amount of vertebral body collapse (VBC).…”