Abstract
Purpose
To explore the efficacy of secondary balloon kyphoplasty (BKP) for new vertebral compression fracture (NVCF) of previously non-fractured, non-treated vertebrae after previous BKP and to compare the therapeutic effect between patients with single-level adjacent NVCF and remote NVCF.
Methods
We retrospectively studied patients with single-level NVCF after initial BKP in our hospital from January 2007 to August 2014. The mean follow-up time from secondary BKP was 13.78 ± 3.18 (12–24) months. Visual analog scale (VAS) and Oswestry disability index (ODI) scores were assessed prior to the initial BKP, one day after initial BKP, prior to the secondary BKP, one day after the secondary BKP, and at last follow-up. Kyphotic angle and vertebral heights were also compared for secondary BKP. Data were compared between patients with adjacent NVCF and remote NVCF.
Results
36 patients were investigated. Compared with pre-operative value of initial and secondary BKP, patients in both groups gained statistical significant improvements for VAS and ODI after initial and secondary BKP, respectively (P < 0.05), and this improvement maintained at final follow-up. No statistical difference in VAS was found between the 2 groups after initial BKP and prior to the secondary BKP (P > 0.05), but patients in remote NVCF group achieved better VAS score than patients in adjacent NVCF group after the secondary BKP and at the final follow-up (P < 0.05). No statistical differences were detected in ODI between the 2 groups prior to the initial BKP, one day after initial BKP, prior to the secondary BKP and 1 day after the secondary BKP (P > 0.05), but the ODI scores were higher in adjacent NVCF group than in remote NVCF at last follow-up (P < 0.05). Kyphotic angle and vertebral heights were significantly restored and maintained after secondary BKP within groups, respectively.
Conclusions
Secondary BKP is an effective procedure for treating NVCF after initial BKP. Patients with new fracture in remote level gain slightly better pain relief than those in the adjacent level.
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References
Alvarez L, Alcaraz M, Perez-Higueras A, Granizo JJ, de Miguel I, Rossi RE, Quinones D (2006) Percutaneous vertebroplasty: functional improvement in patients with osteoporotic compression fractures. Spine 31:1113–1118. doi:10.1097/01.brs.0000216487.97965.38
Lieberman IH, Dudeney S, Reinhardt MK, Bell G (2001) Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine 26:1631–1638
Eck JC, Nachtigall D, Humphreys SC, Hodges SD (2008) Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature. Spine J 8:488–497. doi:10.1016/j.spinee.2007.04.004
Trout AT, Kallmes DF (2006) Does vertebroplasty cause incident vertebral fractures? A review of available data. AJNR Am J Neuroradiol 27:1397–1403
Lamy O, Uebelhart B, Aubry-Rozier B (2013) Risks and benefits of percutaneous vertebroplasty or kyphoplasty in the management of osteoporotic vertebral fractures. Osteoporos Int. doi:10.1007/s00198-013-2574-4
Chiu YC, Yang SC, Chen HS, Kao YH, Tu YK, Chung KC (2012) Clinical evaluation of repeat percutaneous vertebroplasty for symptomatic cemented vertebrae. J Spinal Disord Tech 25:E245–E253. doi:10.1097/BSD.0b013e31825ef90f
Gaughen JR Jr, Jensen ME, Schweickert PA, Marx WF, Kallmes DF (2002) The therapeutic benefit of repeat percutaneous vertebroplasty at previously treated vertebral levels. AJNR Am J Neuroradiol 23:1657–1661
He SC, Teng GJ, Deng G, Fang W, Guo JH, Zhu GY, Li GZ (2008) Repeat vertebroplasty for unrelieved pain at previously treated vertebral levels with osteoporotic vertebral compression fractures. Spine 33:640–647. doi:10.1097/BRS.0b013e318166955f
Doo TH, Shin DA, Kim HI, Shin DG, Kim HJ, Chung JH, Lee JO (2008) Clinical relevance of pain patterns in osteoporotic vertebral compression fractures. J Korean Med Sci 23:1005–1010. doi:10.3346/jkms.2008.23.6.1005
Hierholzer J, Fuchs H, Westphalen K, Baumann C, Slotosch C, Schulz R (2008) Incidence of symptomatic vertebral fractures in patients after percutaneous vertebroplasty. Cardiovasc Intervent Radiol 31:1178–1183. doi:10.1007/s00270-008-9376-7
Rho YJ, Choe WJ, Chun YI (2012) Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty. Eur Spine J 21:905–911. doi:10.1007/s00586-011-2099-5
Lee WS, Sung KH, Jeong HT, Sung YS, Hyun YI, Choi JY, Lee KS, Ok CS, Choi YW (2006) Risk factors of developing new symptomatic vertebral compression fractures after percutaneous vertebroplasty in osteoporotic patients. Eur Spine J 15:1777–1783. doi:10.1007/s00586-006-0151-7
Center JR, Bliuc D, Nguyen TV, Eisman JA (2007) Risk of subsequent fracture after low-trauma fracture in men and women. JAMA 297:387–394. doi:10.1001/jama.297.4.387
Berlemann U, Ferguson SJ, Nolte LP, Heini PF (2002) Adjacent vertebral failure after vertebroplasty. A biomechanical investigation. J Bone Joint Surg Br 84:748–752
Polikeit A, Nolte LP, Ferguson SJ (2003) The effect of cement augmentation on the load transfer in an osteoporotic functional spinal unit: finite-element analysis. Spine 28:991–996. doi:10.1097/01.brs.0000061987.71624.17
Hulme PA, Krebs J, Ferguson SJ, Berlemann U (2006) Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine 31:1983–2001. doi:10.1097/01.brs.0000229254.89952.6b
Fahim DK, Sun K, Tawackoli W, Mendel E, Rhines LD, Burton AW, Kim DH, Ehni BL, Liebschner MA (2011) Premature adjacent vertebral fracture after vertebroplasty: a biomechanical study. Neurosurgery 69:733–744. doi:10.1227/NEU.0b013e31821cc499
Hulme PA, Boyd SK, Heini PF, Ferguson SJ (2009) Differences in endplate deformation of the adjacent and augmented vertebra following cement augmentation. Eur Spine J 18:614–623. doi:10.1007/s00586-009-0910-3
Luo J, Skrzypiec DM, Pollintine P, Adams MA, Annesley-Williams DJ, Dolan P (2007) Mechanical efficacy of vertebroplasty: influence of cement type, BMD, fracture severity, and disc degeneration. Bone 40:1110–1119. doi:10.1016/j.bone.2006.11.021
Luo J, Adams MA, Dolan P (2010) Vertebroplasty and kyphoplasty can restore normal spine mechanics following osteoporotic vertebral fracture. J Osteoporos 2010:729257. doi:10.4061/2010/729257
Luo J, Bertram W, Sangar D, Adams MA, Annesley-Williams DJ, Dolan P (2010) Is kyphoplasty better than vertebroplasty in restoring normal mechanical function to an injured spine? Bone 46:1050–1057. doi:10.1016/j.bone.2009.11.036
Landham PR, Baker-Rand HL, Gilbert SJ, Pollintine P, Annesley-Williams DJ, Adams MA, Dolan P (2015) Is kyphoplasty better than vertebroplasty at restoring form and function after severe vertebral wedge fractures? Spine J 15:721–732. doi:10.1016/j.spinee.2014.11.017
Klazen CA, Lohle PN, de Vries J, Jansen FH, Tielbeek AV, Blonk MC, Venmans A, van Rooij WJ, Schoemaker MC, Juttmann JR, Lo TH, Verhaar HJ, van der Graaf Y, van Everdingen KJ, Muller AF, Elgersma OE, Halkema DR, Fransen H, Janssens X, Buskens E, Mali WP (2010) Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet 376:1085–1092. doi:10.1016/S0140-6736(10)60954-3
Rousing R, Andersen MO, Jespersen SM, Thomsen K, Lauritsen J (2009) Percutaneous vertebroplasty compared to conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures: three-months follow-up in a clinical randomized study. Spine 34:1349–1354. doi:10.1097/BRS.0b013e3181a4e628
Buchbinder R, Osborne RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, Graves S, Staples MP, Murphy B (2009) A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 361:557–568. doi:10.1056/NEJMoa0900429
Blasco J, Martinez-Ferrer A, Macho J, San Roman L, Pomes J, Carrasco J, Monegal A, Guanabens N, Peris P (2012) Effect of vertebroplasty on pain relief, quality of life, and the incidence of new vertebral fractures: a 12-month randomized follow-up, controlled trial. J Bone Miner Res 27:1159–1166. doi:10.1002/jbmr.1564
Farrokhi MR, Alibai E, Maghami Z (2011) Randomized controlled trial of percutaneous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures. J Neurosurg Spine 14:561–569. doi:10.3171/2010.12.SPINE10286
Han SL, Wan SL, Li QT, Xu DT, Zang HM, Chen NJ, Chen LY, Zhang WP, Luan C, Yang F, Xu ZW (2015) Is vertebroplasty a risk factor for subsequent vertebral fracture, meta-analysis of published evidence? Osteoporos Int 26:113–122. doi:10.1007/s00198-014-2848-5
Song D, Meng B, Gan M, Niu J, Li S, Chen H, Yuan C, Yang H (2014) The incidence of secondary vertebral fracture of vertebral augmentation techniques versus conservative treatment for painful osteoporotic vertebral fractures: a systematic review and meta-analysis. Acta Radiol. doi:10.1177/0284185114544240
Wang H, Sribastav SS, Ye F, Yang C, Wang J, Liu H, Zheng Z (2015) Comparison of percutaneous vertebroplasty and balloon kyphoplasty for the treatment of single level vertebral compression fractures: a meta-analysis of the literature. Pain Physician 18:209–222
Bouza C, Lopez-Cuadrado T, Almendro N, Amate JM (2015) Safety of balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures in Europe: a meta-analysis of randomized controlled trials. Eur Spine J 24:715–723. doi:10.1007/s00586-014-3581-7
Acknowledgments
This work was supported by Grants from National Science Foundation of China (81171689), Jiangsu Province Special Program of Medical Science (BL2012004), Jiangsu Provincial Clinical Orthopedic Center, the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD).
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Song, D., Meng, B., Chen, G. et al. Secondary balloon kyphoplasty for new vertebral compression fracture after initial single-level balloon kyphoplasty for osteoporotic vertebral compression fracture. Eur Spine J 26, 1842–1851 (2017). https://doi.org/10.1007/s00586-016-4784-x
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DOI: https://doi.org/10.1007/s00586-016-4784-x