Percutaneous Kyphoplasty Versus Percutaneous Vertebroplasty for Neurologically Intact Osteoporotic Kümmell’s Disease: A Systematic Review and Meta-Analysis

Abstract

Study Design: Systematic review and meta-analysis. Objective: Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are minimally invasive techniques widely used for the treatment of neurologically intact osteoporotic Kümmell’s disease (KD), but which treatment is preferable remains controversial. Therefore, this study aimed to shed light on this issue. Methods: Six databases were searched for all relevant studies based on the PRISMA guidelines. Two investigators independently conducted a quality assessment, extracted the data and performed all statistical analyses. Results: Eight studies encompassing 438 neurologically intact osteoporotic KD patients met the inclusion criteria. Compared to PVP, PKP was associated with greater improvement in the short- and long-term Cobb angle [SMD = −0.37, P = 0.007; SMD = −0.34, P = 0.012], short-term anterior vertebral height [SMD = 0.43, P = 0.003] and long-term middle vertebral height [SMD = 0.57, P = 0.012] and a lower cement leakage rate [SMD = 0.50, P = 0.003] but produced more consumption (cement injection volume, operative time, fluoroscopy times, intraoperative blood loss and operation cost). However, there were no differences between the 2 procedures in the short- and long-term VAS and ODI scores, long-term anterior vertebral height, overall complications or new vertebral fractures. Conclusions: Both procedures are equally effective for neurologically intact KD in terms of the clinical outcomes, with the exception of a lower cement leakage risk and better radiographic improvement for PKP but greater resource consumption. Based on the evidence available, good clinical judgment should be exercised in the selection of patients for these procedures.

Development and Internal Validation of Supervised Machine Learning Algorithm for Predicting the Risk of Recollapse Following Minimally Invasive Kyphoplasty in Osteoporotic Vertebral Compression Fractures

“…A long-standing perception of IVC as a sign of instability may be a consequence of the fibrocartilaginous membrane surrounding the IVC, which prevents cement diffusion and observes an unsatisfactory bonding between the cement and the surrounding cancellous bone ( 34 ). Thus, it is logically a sign of surgical complications including recollapse and residual low back pain ( 35 , 36 ). Yu et al systematically reviewed substantial studies and summarily reported a significant therapeutic efficacy in OVCF patients with percutaneous vertebral augmentation, but IVC was responsible for more frequent recollapse and unfavorable radiological parameters compared to controls ( 37 ).…”

A Nomogram for Predicting the Residual Back Pain after Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures

“…PVP and PKP are considered the ideal methods to treat OVCFs with IVC [31]. However, some studies still report that the presence of preoperative IVC during long-term follow-up will more or less affect the clinical outcome after PVP, such as vertebral body recollapse, severe over residual back pain, or even compression fractures of adjacent vertebrae [13,32]. e presence of IVC sign in OVCFs has been reported to be a major risk factor for postoperative recollapse of the injured vertebra, progressive kyphosis, and chronic back pain [31,33].…”

Screw Cutting Vertebrae After Short-Segment Fixation of Pedicle Screw Combined with Kyphoplasty for Kummell Disease ： A Case Report and Literature Review

“…PVP or PKP could be used to strengthen the injured vertebrae. Both of them provided similar ain relief, but PKP is superior to PVP in restoring vertebral height and reducing cement leakage [10].…”