A Comparative Analysis of the Results of Vertebroplasty and Kyphoplasty in Osteoporotic Vertebral Compression Fractures

Kumar, Krishna; Nguyen, Ruby H.N.; Bishop, Sharon

doi:10.1227/01.neu.0000380936.00143.11

Cited by 51 publications

(58 citation statements)

References 42 publications

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“…A total of 242 titles and abstracts were preliminarily reviewed, of which 12 studies [11,15,17,22,28,29,33,36,39,41,48,49] eventually satisfied the eligibility criteria ( Fig. 1).…”

Section: Search Resultsmentioning

confidence: 99%

“…1). These studies included one randomized controlled trial [28], three clinical controlled trials [15,36,41], five prospective cohort studies [11,22,29,33,39], three retrospective cohort studies [17,48,49] and no retrospective case series study. In total, 1081 patients and 1332 vertebral bodies were included in the 12 studies.…”

Section: Search Resultsmentioning

confidence: 99%

“…Among the 12 included studies, only 1 RCT [28] had a low risk of bias, and the remaining 11 non-RCT [11,15,17,22,29,33,36,39,41,48,49] studies had a high risk of bias resulting from study design limitations. Only one trial [28] reported an adequately generated allocation sequence, and two trials [28,36] reported allocation concealment.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…In the subgroup analysis, we pooled the outcome values by study design. Seven studies [11,15,22,28,33,36,41] reported short-term VAS scores. The CCT subgroup analysis did not find a significant difference between the KP and VP groups.…”

Section: Primary Outcomesmentioning

confidence: 99%

“…Two studies [22,36] reported short-term ODI scores. The KP and VP patients did not differ significantly in the CCT subgroup analysis.…”

Section: Primary Outcomesmentioning

confidence: 99%

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Balloon kyphoplasty versus percutaneous vertebroplasty in treating osteoporotic vertebral compression fracture: grading the evidence through a systematic review and meta-analysis

Xing

et al. 2012

Eur Spine J

114

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Objective To assess the safety and efficacy of balloon kyphoplasty (KP) compared with percutaneous vertebroplasty (VP) and provide recommendations for using these procedures to treat osteoporotic vertebral compression fractures (OVCF). Methods A systematic search of all studies published through March 2012 was conducted using the MEDLINE, EMBASE, OVID, ScienceDirect and Cochrane CENTRAL databases. The randomized controlled trials (RCTs) and non-randomized controlled trials that compared KP to VP and provided data on safety and clinical effects were identified. Demographic characteristics, adverse events and clinical outcomes were manually extracted from all of the selected studies. The evidence quality levels and recommendations were assessed using the GRADE system. Results Twelve studies encompassing 1,081 patients met the inclusion criteria. Subgroup meta-analyses were performed according to the study design. In the RCT subgroup, there were significant differences between the two procedures in short-term visual analog scale (VAS), long-term kyphosis angles, operative times and anterior vertebrae heights. In the cohort study subgroup, there were significant differences between the two procedures in short-and longterm VAS, short-and long-term Oswestry Disability Index (ODI), cement leakage rates, short-and long-term kyphosis angles, operative times and anterior vertebrae heights. However, there were no significant differences in long-term VAS or adjacent vertebral fracture rates in the RCT subgroup. There were no significant differences in short-or long-term VAS, short-or long-term ODI, cement leakage rates, adjacent vertebral fracture rates, short-or long-term kyphosis angles or anterior vertebrae heights in the CCT subgroup, and the adjacent vertebral fracture rates did not differ significantly in the cohort study subgroup. The overall GRADE system evidence quality was very low, which lowers our confidence in their recommendations. Conclusions KP and VP are both safe and effective surgical procedures for treating OVCF. KP may be superior to VP in patients with large kyphosis angles, vertebral fissures, fractures in the posterior edge of the vertebral body or significant height loss in the fractured vertebrae. Due to the poor quality of the evidence currently available, highquality RCTs are required.

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“…A total of 242 titles and abstracts were preliminarily reviewed, of which 12 studies [11,15,17,22,28,29,33,36,39,41,48,49] eventually satisfied the eligibility criteria ( Fig. 1).…”

Section: Search Resultsmentioning

confidence: 99%

Section: Search Resultsmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

Section: Primary Outcomesmentioning

confidence: 99%

“…Two studies [22,36] reported short-term ODI scores. The KP and VP patients did not differ significantly in the CCT subgroup analysis.…”

Section: Primary Outcomesmentioning

confidence: 99%

See 3 more Smart Citations

Balloon kyphoplasty versus percutaneous vertebroplasty in treating osteoporotic vertebral compression fracture: grading the evidence through a systematic review and meta-analysis

Xing

et al. 2012

Eur Spine J

114

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Risk factors for the development of vertebral fractures after percutaneous vertebroplasty

Martinez-Ferrer

Blasco

Macho

et al. 2013

Journal of Bone and Mineral Research

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We have recently observed an increased risk for vertebral fractures (VF) in a randomized controlled trial comparing the analgesic effect of vertebroplasty (VP) versus conservative treatment in symptomatic VF. The aim of the present study was to evaluate the risk factors related to the development of VF after VP in these patients. We evaluated risk factors including age, gender, bone mineral density, the number, type, and severity of vertebral deformities at baseline, the number of vertebral bodies treated, the presence and location of disk cement leakage, bone remodeling (determining bone turnover markers) and 25 hydroxyvitamin D [25(OH)D] levels at baseline in all patients. Twenty-nine radiologically new VF were observed in 17 of 57 patients undergoing VP, 72% adjacent to the VP. Patients developing VF after VP showed an increased prevalence of 25(OH)D deficiency (<20 ng/mL) and higher P1NP values. The principal factor related to the development of VF after VP in multivariate analysis was 25(OH)D levels < 20 ng/mL (RR, 15.47; 95% CI, 2.99-79.86, p < 0.0001), whereas age >80 years (RR, 3.20; 95% CI, 1.70-6.03, p ¼ 0.0007) and glucocorticoid therapy (RR, 3.64; 95% CI, 1.61-8.26, p ¼ 0.0055) constituted the principal factors in the overall study population. Increased risk of VF after VP was also associated with cement leakage into the inferior disk (RR, 6.14; 95% CI, 1.65-22.78, p ¼ 0.044) and more than one vertebral body treated during VP (RR, 4.19; 95% CI, 1.03-34.3, p ¼ 0.044).In conclusion, nearly 30% of patients with osteoporotic VF treated with VP had a new VF after the procedure. Age, especially >80 years, the presence of inferior disk cement leakage after the procedure, the number of cemented vertebrae, and low 25(OH)D serum levels were related to the development of new VF in these patients, with the latter indicating the need to correct vitamin D deficiency prior to performing VP.

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Comparison of the Efficacy Between Two Micro‐Operative Therapies of Old Patients With Osteoporotic Vertebral Compression Fracture: A Network Meta‐Analysis

Zhang

Shi

Tang

et al. 2017

J of Cellular Biochemistry

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Osteoporotic vertebral compression fracture (OVCF) afflicts most aged people. Except for conservative therapy (CT), percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are another two the common choices, but current evaluation of their efficacy is not performed. All the trial data were originated from electronic database including PubMed, Embase, and Cochrane Library. Four indicators with mean difference (MD) or odd ratio (OR) with their 95% credible interval (95% CrI) were analyzed to evaluate the efficacy, including the value of visual analog scale (VAS), Oswestry disability index (ODI), relieving kyphotic angle (KA), and rate of fracture. Besides, the results were demonstrated in the forest plots and slash tables. Furthermore, the surface under the cumulative ranking curve (SUCRA) was calculated. A total of 32 trials among 2,852 patients are included. Using network comparison, we found that PKP and PVP both have good performance as OVCF treatments. However, in different aspects, PKP seemed to be the best to eliminate pain with high value of SUCRA on ODI and VAS (0.624 and 0.588, respectively), and PVP had better performance in KA and decreasing incidence of fracture. The micro-operative therapy, both PKP and PVP, had better efficacy than CT in four aspects. And PKP was better in pain alleviating, according to VAS and ODI results, while PVP had the superiority in KA and reducing the incidence of fracture. J. Cell. Biochem. 118: 3205-3212, 2017. © 2017 Wiley Periodicals, Inc.

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A Comparative Analysis of the Results of Vertebroplasty and Kyphoplasty in Osteoporotic Vertebral Compression Fractures

Abstract: Both vertebroplasty and kyphoplasty are effective at improving pain, functional disability, and quality of life; however, kyphoplasty provides better results, which are maintained over long-term follow-up.

Cited by 51 publications

References 42 publications

Balloon kyphoplasty versus percutaneous vertebroplasty in treating osteoporotic vertebral compression fracture: grading the evidence through a systematic review and meta-analysis

Balloon kyphoplasty versus percutaneous vertebroplasty in treating osteoporotic vertebral compression fracture: grading the evidence through a systematic review and meta-analysis

Risk factors for the development of vertebral fractures after percutaneous vertebroplasty

Comparison of the Efficacy Between Two Micro‐Operative Therapies of Old Patients With Osteoporotic Vertebral Compression Fracture: A Network Meta‐Analysis

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