Kyphoplasty Increases Vertebral Height, Decreases Both Pain Score and Opiate Requirements While Improving Functional Status

Tolba, Reda; Bolash, Robert; Shroll, Joshua; Costandi, Shrif; Dalton, Jarrod E.; Sanghvi, Chirag; Mekhail, Nagy

doi:10.1111/papr.12131

Cited by 16 publications

(8 citation statements)

References 34 publications

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“…It was determined that the procedure increases vertebral height by nearly 42% and improves function while decreasing pain and the need for opioid analgesics. 68 Similar results were also obtained by Zarate et al, who observed a reduction in pain for the full 2-year follow-up. 69 A substantial amount of literature compares the two original vertebral augmentation procedures, vertebroplasty and kyphoplasty.…”

Section: Kyphoplastysupporting

confidence: 80%

Spinal Compression Fracture Management

Genev

Tobin

Zaidi

et al. 2017

Global Spine Journal

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Study DesignNarrative review.ObjectiveDespite the numerous treatment options for vertebral compression fractures, a consensus opinion for the management of patients with these factures has not been established. This review is meant to provide an up-to-date overview of the most common treatment strategies for compression fractures and to suggest possible routes for the development of clearer treatment guidelines.MethodsA comprehensive database search of PubMed was performed. All results from the past 30 years were obtained and evaluated based on title and abstract. The full length of relevant studies was analyzed for level of evidence, and the strongest studies were used in this review.ResultsThe major treatment strategies for patients with compression fractures are conservative pain management and vertebral augmentation. Despite potential adverse effects, medical management, including nonsteroidal anti-inflammatory drugs, calcitonin, teriparatide, and bisphosphonates, remains the first-line therapy for patients. Evidence suggests that vertebral augmentation, especially some of the newer procedures, have the potential to dramatically reduce pain and improve quality of life. At this time, balloon-assisted kyphoplasty is the procedure with the most evidence of support.ConclusionsBased on current literature, it is evident that there is a lack of standard of care for patients with vertebral compression fractures, which is either due to lack of evidence that a procedure is successful or due to serious adverse effects encountered with prolonged treatment. For a consensus to be reached, prospective clinical trials need to be formulated with potential new biomarkers to assess efficacy of treatment strategies.

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Section: Kyphoplastysupporting

confidence: 80%

Spinal Compression Fracture Management

Genev

Tobin

Zaidi

et al. 2017

Global Spine Journal

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“…Many studies have shown the effectiveness of kyphoplasty in restoring vertebral height and relieving pain. [4][5][6]8] Kyphoplasty involves placing a balloon into the vertebral body and creating a void within that body that can then be filled cement injected under lower pressures, to reduce the risk of cement leakage. [7] Here, we uniquely correlated cement volumes injected with pain, disability, and quality of life indices in those undergoing percutaneous kyphoplasty for the treatment of vertebral compression fractures.…”

Section: Introductionmentioning

confidence: 99%

Analysis of injected cement volume and clinical outcomes following kyphoplasty for vertebral compression fractures

Self

Mooney

Amburgy

et al. 2020

Surgical Neurology International

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Background: It has been suggested that greater volumes of cement injected during kyphoplasty correlate with improved vertebral body height restoration and kyphotic angulation correction. However, there is little evidence tying cement volume to patient outcomes. Here, we analyzed the association between cement volume and outcome utilizing indices of pain, disability, and quality of life. Methods: One hundred and thirty-six patients undergoing kyphoplasty were analyzed retrospectively. The total volume of bone cement injected was recorded intraoperatively for each patient; the average total cement volume was 5.44 cc. Pre- and postoperative outcome indices were documented, using the visual analog scale (VAS), Roland-Morris disability index (RMDI), and the EuroQol 5 Dimension instrument (EQ5D). Pearson’s correlations and linear regression models were derived for the association of total cement volume with each of the patient outcome measures. This was a retrospective cohort study. Results: The average change in VAS, RMDI, and EQ5D scores for all patients was −6.8, +8.3, and +0.41, respectively. For VAS, RMDI, and EQ5D improvements, neither Pearson’s correlations nor multiple linear regression models revealed a correlation or an association with total cement volume. Conclusion: For patients undergoing kyphoplasty, outcomes were not associated with the total injected cement volume; all had a significant reduction in pain and most exhibited decreased disability with improved quality of life.

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“…Importantly, previous opioid consumers were able to decrease their opioid consumption by 48%, which was VWDWLVWLFDOO\ VLJQL¿FDQW 2XU UHVXOWV DUH LQ FRQJUXLW\ ZLWK WKH ¿QGLQJV RI RWKHU VLPLODU studies. 22,24 Our analysis also showed that neither gender nor vertebral level (thoracic vs. OXPEDU KDG DQ\ LQÀXHQFH RQ RXU PHDVXUHG outcomes.…”

Section: Discussionmentioning

confidence: 67%

The Clinical Relevance of Cement Volume in Percutaneous Vertebral Augmentation

2020

GMERJ

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Introduction: Vertebroplasty and Kyphoplasty are two forms of percutaneous vertebral augmentation (PVA), in which polymethylmethacrylate cement is used to stabilize vertebral compression fractures (VCF). This study sought to evaluate the relationship between cement volume and clinical outcomes, including pain reduction, opioid use, and complication rate. Methods: Retrospective chart review produced 88 patients who received PVA at a tertiary care outpatient pain clinic. Cement volume, type of PVA, gender, level (thoracic vs lumbar) were collected, as well as clinical outcomes of numeric pain score (NPS) reduction, opioid percent change (OPC), and complications. Both pre-procedure and post-procedure (between 2-4 weeks) data were collected. Results: Sixty-four patients (72.7%) had statistically significant NPS reduction of ≥50% pain (p Conclusion: Cement volume does not correlate with clinical outcomes of NPS reduction or OPC. Furthermore, our study reinforced PVA as a beneficial treatment for reducing pain and opioid consumption in patients with painful VCF.

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Kyphoplasty Increases Vertebral Height, Decreases Both Pain Score and Opiate Requirements While Improving Functional Status

Cited by 16 publications

References 34 publications

Spinal Compression Fracture Management

Spinal Compression Fracture Management

Analysis of injected cement volume and clinical outcomes following kyphoplasty for vertebral compression fractures

The Clinical Relevance of Cement Volume in Percutaneous Vertebral Augmentation

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