Comparative analysis of clinical outcomes in patients with osteoporotic vertebral compression fractures (OVCFs): conservative treatment versus balloon kyphoplasty

Lee, Hwan Mo; Park, Si Young; Lee, Soon Hyuck; Suh, Seung Woo; Hong, Jae Young

doi:10.1016/j.spinee.2012.08.024

Cited by 101 publications

(72 citation statements)

References 42 publications

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“…Fracture severity may play an additional role, as shown in VERTOS I; as mentioned above both of these parameters were considered dismal prognostic factors in the prospective study by Suzuki et al [5]. Lee et al observed prospectively that severe vertebral body collapse (more than 28.5%) led to failure of conservative management [14]. Burst fractures (type A3.1) had about one-third of the probability for average pain relief compared with wedge-impaction injuries (type A1.1) [15].…”

Section: Discussionmentioning

confidence: 99%

“…In particular, we examined fracture location and fracture severity and related these to the outcomes since they have been implicated as adverse risk factors in other published series [14–18]. Categorical variables were compared using Fisher's exact test and chi-square test was used to detect differences between studies.…”

Section: Methodsmentioning

confidence: 99%

“…Although potential flaws confounding the outcomes have been previously outlined [11–13], they indicate that a subset of patients may not be surgical candidates or have adverse outcome. Location, fracture type, degree of vertebral body collapse and kyphotic angle are identified as possible variables confounding the therapeutic result [14–18]. …”

Section: Introductionmentioning

confidence: 99%

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Adverse Prognostic Factors and Optimal Intervention Time for Kyphoplasty/Vertebroplasty in Osteoporotic Fractures

Papanastassiou

Filis

Aghayev

et al. 2014

BioMed Research International

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Introduction. While evidence supports the efficacy of vertebral augmentation (kyphoplasty and vertebroplasty) for the treatment of osteoporotic fractures, randomized trials disputed the value of vertebroplasty. The aim of this analysis is to determine the subset of patients that may not benefit from surgical intervention and find the optimal intervention time. Methods. 27 prospective multiple-arm studies with cohorts of more than 20 patients were included in this meta-analysis. We hereby report the results from the metaregression and subset analysis of those trials reporting on treatment of osteoporotic fractures with kyphoplasty and/or vertebroplasty. Results. Early intervention (first 7 weeks after fracture) yielded more pain relief. However, spontaneous recovery was encountered in hyperacute fractures (less than 2 weeks old). Patients suffering from thoracic fractures or severely deformed vertebrae tended to report inferior results. We also attempted to formulate a treatment algorithm. Conclusion. Intervention in the hyperacute period should not be pursued, while augmentation after 7 weeks yields less consistent results. In cases of thoracic fractures and significant vertebral collapse, surgeons or interventional radiologists may resort earlier to operation and be less conservative, although those parameters need to be addressed in future randomized trials.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Adverse Prognostic Factors and Optimal Intervention Time for Kyphoplasty/Vertebroplasty in Osteoporotic Fractures

Papanastassiou

Filis

Aghayev

et al. 2014

BioMed Research International

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“…Consequently, these procedures have become a controversial and frequently contested topic [2-4, 6, 8, 11, 12, 16, 18, 20-22, 32, 33, 38, 39]. Since 2009 numerous studies have reported the benefits of vertebroplasty and kyphoplasty relative to conservative medical therapy [2,4,8,12,20,38,39], whereas others have reported either mixed outcomes or data consistent with the 2009 studies [3,21].…”

Section: Introductionmentioning

confidence: 99%

Can Internet Information on Vertebroplasty be a Reliable Means of Patient Self-education?

Sullivan

Ahn

2014

Clinical Orthopaedics &Amp; Related Research

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Background Studies of the quality and accuracy of health and medical information available on the Internet have shown that many sources provide inadequate information. However, to our knowledge, there are no published studies analyzing the quality of information available online regarding vertebroplasty. Because this has been a highvolume procedure with highly debated efficacy, it is critical that patients receive complete, accurate, and well-balanced information before deciding a treatment course. Additionally, few studies have evaluated the merit of academic site authorship or site certification on information quality, but some studies have used measurements of quality that are based primarily on subjective criteria or information accuracy rather than information completeness. Questions/purposes The purposes of our study were (1) to evaluate and analyze the information on vertebroplasty available to the general public through the Internet; (2) to see if sites sponsored by academic institutions offered a higher quality of information; and (3) to determine whether quality of information varied according to site approval by a certification body. Methods Three search engines were used to identify 105 web sites (35 per engine) offering information regarding vertebroplasty. Sites were evaluated for authorship/sponsorship, content, and references cited. Information quality was rated as ''excellent,'' ''high,'' ''moderate,'' ''low,'' or ''unacceptable.'' Sites also were evaluated for contact information to set up an appointment. Data were analyzed as a complete set, then compared between authorship types, and finally evaluated by certification status. Academic sites were compared with other authorship groups and certified sites were compared with noncertified sites using Student's t-test. Results Appropriate indications were referenced in 74% of sites, whereas only 45% discussed a contraindication to the procedure. Benefits were expressed by 100% of sites, but risks were outlined in only 53% (p \ 0.001). Ninety-nine percent of sites provided step-by-step descriptions of the procedure, and 44% of sites also included images. Alternative treatments were mentioned by 51% of sites. Twenty-seven percent of sites referenced peer-reviewed literature, 41% offered experiential or noncited data based on American populations, and 7% offered analogous data from international populations. Thirty percent of sites provided contact information for patient appointment scheduling. Seven percent of sites were classified as excellent quality, 6% as high quality, 11% as moderate quality, 19% as poor quality, and 57% as unacceptable. Sixteen percent of sites were sponsored by academic institutions, 62% by private groups, 8% by biomedical device companies, and 14% were sponsored otherwise. Academic sites reported fewer risks of the procedure than private sites or other sites (p = 0.05 and p = 0.04), but reported more risks Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial a...

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“…About 65% of patients are treated successfully with conservative treatment. Risk factors of failure of 3-weeks conservative treatment are older age (> 78,5 years), severe OP (T-score < -2,95), overweight (BMI > 25,5) and larger collapse rates (> 28,5%) (22). Surgical treatment is indicated for those patients with intractable/unresponsive pain (23-25).…”

Section: Introductionmentioning

confidence: 99%

Underdiagnosis of osteoporotic vertebral fractures in patients with fragility fractures: retrospective analysis of over 300 patients

Bottai

Giannotti

Raffaeta

et al. 2016

ccmbm

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SummaryOsteoporosis (OP) is a silent disease unless a fracture occurs; it is a major health problem, mainly due to fragility fractures, that occur at vertebral and peripheral sites. Vertebral fractures (VF) are probably the most common fragility fractures, but they go often unrecognized. The main clinical symptoms of VF are acute and chronic back pain, spinal deformity, reduced mobility and impaired quality of life. They are frequently associated with other fragility fractures. We examined 478 patients at our outpatient clinic, who were referred for fragility fracture occurrence. The most common fragility fractures was hip fractures. However, after execution of spine X-rays in patients who had sustained hip fracture, we found that a large proportion of them had VF, which had not been reported in their medical history.

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Comparative analysis of clinical outcomes in patients with osteoporotic vertebral compression fractures (OVCFs): conservative treatment versus balloon kyphoplasty

Cited by 101 publications

References 42 publications

Adverse Prognostic Factors and Optimal Intervention Time for Kyphoplasty/Vertebroplasty in Osteoporotic Fractures

Adverse Prognostic Factors and Optimal Intervention Time for Kyphoplasty/Vertebroplasty in Osteoporotic Fractures

Can Internet Information on Vertebroplasty be a Reliable Means of Patient Self-education?

Underdiagnosis of osteoporotic vertebral fractures in patients with fragility fractures: retrospective analysis of over 300 patients

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