Comparative review of vertebroplasty and kyphoplasty

Abstract

The aim of this review is to compare the effectiveness of percutaneous vertebroplasty and kyphoplasty to treat pain and improve functional outcome from vertebral fractures secondary to osteoporosis and tumor conditions. In 2009, two open randomized controlled trials published in the New England Journal of Medicine questioned the value of vertebroplasty in treating vertebral compression fractures. Nevertheless, the practice of physicians treating these conditions has barely changed. The objective of this review is to try to clarify the most important issues, based on our own experience and the reported evidence about both techniques, and to guide towards the most appropriate choice of treatment of vertebral fractures, although many questions still remain unanswered.

Percutaneous stabilization of lumbar spine: a literature review and new options in treating spine pain

“…Low-energy trauma occurs more frequently in females, with an increased prevalence related with the ages, whereas high-energy traumas are more frequent in males and are not related with older age. 1 Pathological VF is secondary to osseous involvement by a localized debilitating condition, mainly tumours. Most are due to malignancies such as myeloma and primary bone tumours.…”

“…The spine is the most affected target by metastases. 1 Anatomically and functionally, the thoracic and lumbar spine can be divided into three regions-thoracic spine (T1-T10), thoracolumbar junction (T10-L2) and the lumbar spine (L3-L5). 2 The narrow spinal canal in this region predisposes to spinal cord damage resulting in a high incidence of neurological deficit.…”

Treatment of Osteoporotic Spine Fractures Using Cement Augmentation: A Mini Review

“…Although, this helped lower the complication rates especially in cement leak to a range of 4.8-39% in some reports. 5 Studies have shown that patients underwent kyphoplasty had immediate pain relief, height restoration with a mean of 4.7 mm mid vertebral body, 7,8 and an average kyphosis correction of 62.4%+/-16.7% (average 6.6°). 7,9 New fractures of adjacent vertebrae occurred for both procedures at rates that are higher than the general osteoporotic population but, approximately equivalent to the general osteoporotic population that had a previous vertebral fracture.…”

“…The reported rate of cement extravasation was 11-76% when computerized tomography (CT) scans where used. 5 If leakage happened into the neural canal it could cause neurologic deficits. Other complications reported includes pulmonary embolism, infection, and incomplete stabilization.…”

Classifying thoracolumbar fractures: role of quantitative imaging

“…A retropulsed bone fragment and the presence of intra vertebral cleft are characteristic of benign compression fractures. Chronic vertebral compression fractures are characterized by morphologic changes with recovery of normal signal of the bone marrow ( Figure 7) (37).…”