Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature

Eck, Jason C.; Nachtigall, Dean; Humphreys, S. Craig; Hodges, Scott D.

doi:10.1016/j.spinee.2007.04.004

Cited by 325 publications

(214 citation statements)

References 127 publications

Supporting

Mentioning

189

Contrasting

Unclassified

Order By: Relevance

“…Two other systematic reviews comparing balloon kyphoplasty to vertebroplasty also did not show significant differences between groups. (23,24) Lee and colleagues reported a meta-analysis of complications after vertebroplasty and kyphoplasty. In prospective studies, the medical complications, symptomatic cement leakage, and mortality all occurred in less that 1% of patients each.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of vertebral augmentation compared with conservative treatment for osteoporotic spinal fractures

Anderson

Froyshteter

Tontz

2012

Journal of Bone and Mineral Research

175

View full text Add to dashboard Cite

Cement augmentation is a controversial treatment for painful vertebral compression fractures (VCF). Our research questions for the meta-analysis were: Is there a clinical and statistical difference in pain relief, functional improvement, and quality of life between conservative care and cement augmentation for VCF and, if so, are they maintained at longer time points? We conducted a search of MEDLINE from January 1980 to July 2011 using PubMed, Cochrane Database of Systematic Reviews and Controlled Trials, CINAHL, and EMBASE. Searches were performed from Medical Subject Headings. Terms ''vertebroplasty'' and ''compression fracture'' were used. The outcome variables of pain, functional measures, health-related quality of life (HRQOL), and new fracture risk were analyzed. A random effects model was chosen. Continuous variables were calculated using the standardized mean difference comparing improvement from baseline of the experimental group with the control group. New vertebral fracture risk was calculated using log odds ratio. Six studies met the criteria. The pain visual analog scale (VAS) mean difference was 0.73 (confidence interval [CI] 0.35, 1.10) for early (<12 weeks) and 0.58 (CI 0.19, 0.97) for late time points (6 to 12 months), favoring vertebroplasty (p < 0.001). The functional outcomes at early and late time points were statistically significant with 1.08 (CI 0.33, 1.82) and 1.16 (CI 0.14, 2.18), respectively. The HRQOL showed superior results of vertebroplasty compared with conservative care at early and late time points of 0.39 (CI 0.16, 0.62) and 0.33 (CI 0.16, 0.51), respectively. Secondary fractures were not statistically different between the groups, 0.065 (CI À0.57, 0.70). This meta-analysis showed greater pain relief, functional recovery, and health-related quality of life with cement augmentation compared with controls. Cement augmentation results were significant in the early (<12 weeks) and the late time points (6 to 12 months). This meta-analysis provides strong evidence in favor of cement augmentation in the treatment of symptomatic

show abstract

Section: Discussionmentioning

confidence: 99%

Meta-analysis of vertebral augmentation compared with conservative treatment for osteoporotic spinal fractures

Anderson

Froyshteter

Tontz

2012

Journal of Bone and Mineral Research

175

View full text Add to dashboard Cite

show abstract

“…The specific advantages claimed for balloon kyphoplasty over percutaneous vertebroplasty consist of cement injection with lower pressure and its ability to reduce fracture deformity [1]. The risk of cement leak during cement augmentation has been reported as 19.7 % with vertebroplasty versus 7.0 % with kyphoplasty [9]. Apparently, the unique ability of BK is the creation of a cavity into the vertebral body, by the balloon inflation, that allows the insertion of very viscous cement at a much lower pressure.…”

Section: Discussionmentioning

confidence: 99%

Respiratory effects, hemodynamic changes and cement leakage during multilevel cement balloon kyphoplasty

et al. 2012

View full text Add to dashboard Cite

Purpose The purpose of this study is to evaluate the effects of multilevel balloon kyphoplasty (BK) on blood pressure, blood gases and cement leakage. Methods This is a prospective study of 63 patients: 31 were treated for osteoporotic vertebral compressive fractures (OVCF) and 32 for osteolytic tumors (OT). Twentysix patients were treated at 1 level, 15 at 2, 2 at 3, 6 at 4, 3 at 5, 4 at 6, 5 at 7 and 2 at 8. PPMA was used in 43 patients and calcium phosphate in 20. All patients were treated under general anesthesia with continuous invasive monitoring of hemodynamic changes, arterial blood gases and peripheral and regional cerebral oxygen saturation.Results Two patients had a transient drop in blood pressure between 21 and 42 % during simultaneous inflation of all four balloons at two levels and three more patients during cement injection (two PMMA, one calcium phosphate). Five patients had a cement leak (7.9 %), which was unrelated to the cement type or number of levels. Blood pressure, end-tidal carbon dioxide partial pressure and arterial oxygen partial pressure decreased statistically, but without any clinical significance after cement insertion. Peripheral and regional cerebral oxygen saturation remained unchanged. One-way ANOVA revealed no difference between these changes when clustered by the groups single level, two levels and three or more levels. Conclusion BK performed under general anesthesia appears to be safe when applied in multiple levels in the same seating provided the balloons are inflated sequentially and not simultaneously and the cement is inserted slowly in a very doughy state. Close monitoring of cardiorespiratory factors is valuable. Its rare circulatory effects are unrelated to the number of levels or the cement type.

show abstract

“…Leakage rates were higher for PV (41%) than KP (9%). The meta-analysis of Eck et al 24 also showed reduced risk of cement leakage with KP in comparison with PV, but PV group had a significantly greater improvement of pain scores.…”

Section: Discussionmentioning

confidence: 93%

Percutaneous vertebroplasty: a comparison between the procedure using the traditional and the new side-opening cannula for osteoporotic vertebral fracture

Figueiredo

Barra

Moraes

et al. 2009

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

-A total of 47 percutaneous vertebroplasties (PVs) were performed for osteoporotic vertebral fractures in 31 patients, 25 PVs were performed using the frontal-opening cannula (FOC) and 22 using the new side-opening cannula (SOC), randomly distributed. The incidence of cement extrusion was 27% with the SOC, and 68% with the FOC, all asymptomatic (p<0.01). The pain control was similar for both groups, with good improvement of pain in most of the patients, and there were no clinical relevant complications. The cement leakage can be significantly reduced with this new SOC, which allows for a better cement injection toward the center of the vertebral body, increasing the safety of the procedure, with no increase in cost.KEY WORDS: percutaneous vertebroplasty, osteoporotic vertebral fractures, cannula.Vertebroplastia percutânea: uma comparação entre o procedimento usando a cânula tradicional e a nova cânula de orifício lateral para fratura vertebral osteoporótica Resumo -Um total de 47 vertebroplastias percutâneas (VP) foram realizadas para fraturas vertebrais osteoporóticas em 31 pacientes, 25 VP foram realizadas usando-se a cânula de orifício frontal (COF) e 22 com a nova cânula de orifício lateral (COL), distribuídos randomicamente. A incidência de extrusão de cimento ortopédico ocorreu em 27% com a COL, e 68% com a COF, todas assintomáticas (p<0,01). O controle da dor foi similar em ambos os grupos, com boa melhora da dor na maioria dos pacientes, sem complicações clínicas relevantes. A extrusão do cimento pode ser significativamente reduzida com esta nova COL, que permite uma melhor injeção do cimento para o centro do corpo vertebral, aumentando a segurança do procedimento, sem aumento no seu custo. PALAVRAS-CHAVE: vertebroplastia percutânea, fratura vertebral osteoporótica, cânula.

show abstract

Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature

Cited by 325 publications

References 127 publications

Meta-analysis of vertebral augmentation compared with conservative treatment for osteoporotic spinal fractures

Meta-analysis of vertebral augmentation compared with conservative treatment for osteoporotic spinal fractures

Respiratory effects, hemodynamic changes and cement leakage during multilevel cement balloon kyphoplasty

Percutaneous vertebroplasty: a comparison between the procedure using the traditional and the new side-opening cannula for osteoporotic vertebral fracture

Contact Info

Product

Resources

About