In Not Only Vertebroplasty but Also Kyphoplasty, the Resolution of Vertebral Deformities Depends on Vertebral Mobility

Yokoyama, Kunio; Kawanishi, Masahiro; Yamada, Makoto; Tanaka, Hidekazu; Ito, Yutaka; Hirano, Masashi; Kuroiwa, Toshihiko

doi:10.3174/ajnr.a3424

Cited by 20 publications

(20 citation statements)

References 19 publications

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“…17 , 26 – 56 ( Figure 1 ). They included 4 RCTs, 27 , 31 , 41 , 53 14 prospective cohort studiess, 17 , 32 , 33 , 36 , 39 , 40 , 41 – 49 , 54 and 14 retrospective cohort studies 26 , 28 – 30 , 34 , 35 , 37 , 38 , 42 , 50 – 52 , 55 , 56 ( Figures 2 and 3 ). There were a total of 3274 patients; 1653 patients underwent the KP surgery and 1621 underwent VP surgery.…”

Section: Resultsmentioning

confidence: 99%

Balloon kyphoplasty or percutaneous vertebroplasty for osteoporotic vertebral compression fracture? An updated systematic review and meta-analysis

Liang¹,

Chen

Jiang

et al. 2016

Annals of Saudi Medicine

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BACKGROUNDBoth kyphoplasty (KP) and vertebroplasty (VP) are effective for patients with osteoporotic vertebral compression fracture (OVCF), but which approach might be more effective remains unclear, so we decided to update earlier systematic reviews.OBJECTIVEReview and analyze studies published as of August 2015 that compared clinical outcomes and complications of KP versus VP.DESIGNSystematic review and meta-analysis.SEARCH METHODPublished reports up to August 2015 were found in PubMed, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL).SELECTION CRITERIARandomized controlled trials (RCTs) and prospective and retrospective cohort studies comparing KP and VP in patients with OVCF.DATA COLLECTION AND ANALYSISTwo authors independently assessed the studies and extracted data.RESULTSThirty-two studies involving 3274 patients fulfilled the inclusion criteria. There were significant differences between the two groups in short- and long-term postoperative changes in measures of pain intensity and dysfunction (P<.01), in anterior and middle height (P<.01), kyphotic angle (P<.01), and time to injury, but not in posterior height (P=.178). There were no significant differences in the rate of postoperative fractures including adjacent and total fractures, but cement leakage to the intraspinal space was greater in the VP group (P=.035). KP surgery took longer and required a greater volume of injected cement.CONCLUSIONSKR resulted in better pain relief, improvements in Oswestry dysfunction and radiographic outcomes with less cement leakage, but further RCTs are needed to verify this conclusion.LIMITATIONSOnly four RCTs with a certain of risk of bias. Most studies were observational.

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Section: Resultsmentioning

confidence: 99%

Balloon kyphoplasty or percutaneous vertebroplasty for osteoporotic vertebral compression fracture? An updated systematic review and meta-analysis

Liang¹,

Chen

Jiang

et al. 2016

Annals of Saudi Medicine

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“…A meta-analysis found improvements in pain intensity, vertebral height, sagittal alignment, functional capacity, and quality of life with BK as compared with conventional medical management [75]. Multiple other studies demonstrated the benefit of VA for alignment with improvement in pain relief [19,[76][77][78], and respiratory function [79][80][81]. In a multisociety position statement, it was concluded that VA of osteoporotic VCF is clearly beneficial in the short term and likely beneficial also in the long term [33].…”

Section: Discussion Of Procedures By Variant Variant 1: New Symptomatmentioning

confidence: 99%

“…This results in decreased respiratory capacity by 25% to 50% [16]. Multiple studies have demonstrated the benefit of VA for alignment with improvement in pain relief [19,[76][77][78] and respiratory function [79][80][81]. Multidisciplinary case discussion is warranted prior to intervention.…”

Section: Variant 7: Pathologic Spinal Fracture With Spinal Deformity mentioning

confidence: 99%

ACR Appropriateness Criteria® Management of Vertebral Compression Fractures

Shah

Jennings

Kirsch

et al. 2018

Journal of the American College of Radiology

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Vertebral compression fractures (VCFs) have various causes, including osteoporosis, neoplasms, and acute trauma. As painful VCFs may contribute to general physical deconditioning, management of painful VCFs has the potential for improving quality of life and preventing superimposed medical complications. Various imaging modalities can be used to evaluate a VCF to help determine the etiology and guide intervention. The first-line treatment of painful VCFs has been nonoperative or conservative management as most VCFs show gradual improvement in pain over 2 to 12 weeks, with variable return of function. There is evidence that vertebral augmentation (VA) is associated with better pain relief and improved functional outcomes compared to conservative therapy for osteoporotic VCFs. A multidisciplinary approach is necessary for the management of painful pathologic VCFs, with management strategies including medications to affect bone turnover, radiation therapy, and interventions such as VA and percutaneous thermal ablation to alleviate symptoms.

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“…Reduction of kyphosis with KP varies from 3.7° to 8° (mean 4.8°) whereas with VP it ranges from 0.5° to 3° (mean 1.7°) [10]. While some surgeons view that postural reduction is the most critical factor determining kyphotic postprocedural correction [56–58], or claiming equivalent (or superior) results with nonballoon KPs [59, 60], other authors [61] as well as the extensive literature documentation with balloon KPs stresses the fact that balloon inflation also plays a role. Another important issue is whether this degree of kyphotic reduction correlates with clinical improvement.…”

Section: Vaps and Kyphotic Reduction/vertebral Height Restorationmentioning

confidence: 99%

Controversial Issues in Kyphoplasty and Vertebroplasty in Osteoporotic Vertebral Fractures

Papanastassiou

Filis

Gerochristou

et al. 2014

BioMed Research International

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Kyphoplasty (KP) and vertebroplasty (VP) have been successfully employed for many years for the treatment of osteoporotic vertebral fractures. The purpose of this review is to resolve the controversial issues raised by the two randomized trials that claimed no difference between VP and SHAM procedure. In particular we compare nonsurgical management (NSM) and KP and VP, in terms of clinical parameters (pain, disability, quality of life, and new fractures), cost-effectiveness, radiological variables (kyphosis correction and vertebral height restoration), and VP versus KP for cement extravasation and complications profile. Cement types and optimal filling are analyzed and technological innovations are presented. Finally unipedicular/bipedicular techniques are compared. Conclusion. VP and KP are superior to NSM in clinical and radiological parameters and probably more cost-effective. KP is superior to VP in sagittal balance improvement and cement leaking. Complications are rare but serious adverse events have been described, so caution should be exerted. Unilateral procedures should be pursued whenever feasible. Upcoming randomized trials (CEEP, OSTEO-6, STIC-2, and VERTOS IV) will provide the missing link.

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In Not Only Vertebroplasty but Also Kyphoplasty, the Resolution of Vertebral Deformities Depends on Vertebral Mobility

Cited by 20 publications

References 19 publications

Balloon kyphoplasty or percutaneous vertebroplasty for osteoporotic vertebral compression fracture? An updated systematic review and meta-analysis

Balloon kyphoplasty or percutaneous vertebroplasty for osteoporotic vertebral compression fracture? An updated systematic review and meta-analysis

ACR Appropriateness Criteria® Management of Vertebral Compression Fractures

Controversial Issues in Kyphoplasty and Vertebroplasty in Osteoporotic Vertebral Fractures

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