Therapeutic effects of new-type hydraulic delivery vertebroplasty, balloon kyphoplasty and conventional pusher-type vertebroplasty on single segmental osteoporotic vertebral compression fracture

Abstract

This study aims to evaluate safety and practicality in clinical application for better guidance of single segmental osteoporotic vertebral compression fractures treatment. From May 2012 to September 2013, a total of 188 cases of patients with fractures, who received different treatment, were incorporated in the study and then divided into: group A (n=59), conventional pusher-type vertebroplasty; group B (n=54), balloon kyphoplasty; group C (n=60), new-type hydraulic delivery vertebroplasty treatment. The overall follow-up rate was 92.02%. Postoperative visual analogue scale (VAS) and Oswestry disability index (ODI) scores were significantly improved more than those of the preoperative scores in the three groups. Bone cement injection volumes in group A were significantly lower than those in group B and group C. Vertebral height recovery rates among groups were obviously different, showing statistical significance. After a year of follow-up, the vertebral height recovery outcome in group A was obviously poorer than that in group B and group C. A poorer outcome in group B was also found when compared with group C. In addition, the vertebral height restoration had a certain degree of loss, with the loss rate of 20.5, 14.0 and 7.5% in the three groups, respectively. Three operation methods have equivalent effects in the improvement of symptoms and functional recovery. Therefore, the new-type hydraulic delivery vertebroplasty provides a relatively more concise operation and shorter operation time, displaying more outstanding performance of clinical efficacy in spinal reconstruction and reduction of complications risks by evaluating the diffusion of the bone cement, vertebral height restoration rate and postoperative complications.

Balloon Kyphoplasty vs Vertebroplasty: A Systematic Review of Height Restoration in Osteoporotic Vertebral Compression Fractures

“…There were 3 studies that examined ODI scores in head-to-head comparisons between balloon kyphoplasty and vertebroplasty, and follow-up ranged from 6 to 24 months. 43 , 47 , 48 All 3 studies demonstrated significantly lower postoperative ODI scores in each group, though there was no significant between-group difference. 43 , 47 , 48 One study demonstrated significantly lower ODI scores 1 month after treatment in the kyphoplasty group, though by 6 months, this between-group difference was not maintained.…”

“…A total of 6 studies compared vertebroplasty head-to-head with balloon kyphoplasty and evaluated preoperative and postoperative pain scores. 43–45 , 47 , 48 Liu et al’s 2010 paper, Endres et al, and Zhang et al reported no significant difference in 6-month postoperative VAS scores when comparing either system. 43 , 45 , 48 Similarly, Lie et al’s 2015 paper and Wang et al reported no significant difference in postoperative VAS scores at 12 months between the 2 systems.…”

“… 43–45 , 47 , 48 Liu et al’s 2010 paper, Endres et al, and Zhang et al reported no significant difference in 6-month postoperative VAS scores when comparing either system. 43 , 45 , 48 Similarly, Lie et al’s 2015 paper and Wang et al reported no significant difference in postoperative VAS scores at 12 months between the 2 systems. 44 , 47 In addition, Liu et al’s follow-up study in 2015 reported no significant difference in mean VAS scores between groups at 2- and 5-year follow-up.…”

“…47 Zhang et al’s study comparing vertebroplasty to kyphoplasty reported a mean cement volume of 4.60 ± 1.00 mL injected in the kyphoplasty group compared to 3.41 ± 1.30 mL in the vertebroplasty group, and at 1-year follow-up, the vertebral height recovery rate in the vertebroplasty group was 16.14 ± 3.33% compared to 26.24 ± 2.12% in the kyphoplasty group, which was a statistically significant difference. 48 Endres et al reported a mean cement volume of 3.1 mL injected in the vertebroplasty group and 3.9 mL in the balloon kyphoplasty group and compared the pre- and postoperative Beck index (anterior edge height/posterior edge height) between balloon kyphoplasty, shield kyphoplasty, and vertebroplasty and did not find any significant change in the Beck index at 6-month follow-up, correlating with no significant increase in vertebral body height. 43 Overall, 3 of the 6 head-to-head studies demonstrated a correlation between larger volume of cement injected and improved vertebral body height, favoring balloon kyphoplasty, and 5 of the 6 head-to-head studies favored balloon kyphoplasty for height restoration, with 2 of these studies showing a statistically significant between-group difference.…”

Clinical study of unilateral Percutaneous vertebra plasty(PVP) in the treatment of Osteoporotic vertebral compression fractures(OVCF) in the elderly

“…Vertebral microfractures are the main cause of OVCF pain [12] . Studies have shown that micro-fractures of the vertebral body can lead to changes in the mechanical stress of the vertebral body and local inflammatory reactions, stimulating or compressing the nerves and causing pain [13] . PVP can repair microfractures of the vertebral body, reduce mechanical stress, relieve inflammatory reactions, thereby reduce nerve compression and stimulation, and relieve or relieve pain [14] .…”