Abstract
Background: Osteoporotic vertebral compression fracture (OVCF) is the most common complication of osteoporosis, however, debate persists over which procedure of percutaneous vertebroplasty (PVP) or balloon kyphoplasty (BKP) is a better treatment. We performed a metaanalysis of prospective, randomized controlled and clinical controlled trials of PVP and BKP to determine the efficacy and safety for the treatment of OVCFs to reach a relatively conclusive answer.
Materials and Methods: We searched computerized databases comparing efficacy and safety of PVP and BKP in osteoporotic vertebral compression fractures. These reports included pain relief, functional capacity (Oswestry disability index [ODI] score), anterior vertebral body height (AVBH), kyphotic angle and complications (i.e. cement leakage, incident fractures). Studies were assessed for methodological bias and potential reasons for heterogeneity were explored.
Results: As of March 15, 2013, a PubMed search resulted in 761 articles, of which eleven studies encompassing 789 patients, met the inclusion criteria. The average length of followup is 17 months and 4.6% patients were lost to followup. Results of metaanalysis indicated that BKP is more effective for short term pain relief. In addition, BKP is more effective to restore the AVBH (anterior vertebral body height), ODI and kyphotic angle of OVCFs. Moreover, BKP need more polymethylmethacrylate amount.
Conclusions: In terms of better effectiveness of BKP procedure, we believe BKP to be superior over PVP for the treatment of osteoporotic VCFs.
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References
European Prospective Osteoporosis Study (EPOS) Group, Felsenberg D, Silman AJ, Lunt M, Armbrecht G, Ismail AA, et al. Incidence of vertebral fracture in Europe: Results from the European Prospective Osteoporosis Study (EPOS). J Bone Miner Res 2002;17:716–24.
Dennison E, Cooper C. Epidemiology of osteoporotic fractures. Horm Res 2000;54 Suppl 1:58–63.
Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, et al. Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: A randomized controlled trial. Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. JAMA 1999;282:1344–52.
Phillips FM. Minimally invasive treatments of osteoporotic vertebral compression fractures. Spine 2003;28 15 Suppl: S45–53.
Yan D, Duan L, Li J, Soo C, Zhu H, Zhang Z. Comparative study of percutaneous vertebroplasty and kyphoplasty in the treatment of osteoporotic vertebral compression fractures. Arch Orthop Trauma Surg 2011;131:645–50.
Galibert P, Deramond H, Rosat P, Le Gars D. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 1987;33:166–8.
Eck JC, Nachtigall D, Humphreys SC, Hodges SD. Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: A meta-analysis of the literature. Spine 2008;8:488–97.
Lee MJ, Dumonski M, Cahill P, Stanley T, Park D, Singh K. Percutaneous treatment of vertebral compression fractures: A meta-analysis of complications. Spine (Phila Pa 1976) 2009;34:1228–32.
Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 1998;52:377–84.
Taylor RS, Van Buyten JP, Buchser E. Spinal cord stimulation for chronic back and leg pain and failed back surgery syndrome: A systematic review and analysis of prognostic factors. Spine (Phila Pa 1976) 2005;30:152–60.
Santiago FR, Abela AP, Alvarez LG, Osuna RM, García Mdel M. Pain and functional outcome after vertebroplasty and kyphoplasty. A comparative study. Eur J Radiol 2010;75:e108–13.
Kumar K, Nguyen R, Bishop S. A comparative analysis of the results of vertebroplasty and kyphoplasty in osteoporotic vertebral compression fractures. Neurosurgery 2010;67:171–88.
De Negri P, Tirri T, Paternoster G, Modano P. Treatment of painful osteoporotic or traumatic vertebral compression fractures by percutaneous vertebral augmentation procedures: A nonrandomized comparison between vertebroplasty and kyphoplasty. Clin J Pain 2007;23:425–30.
Bae H, Shen M, Maurer P, Peppelman W, Beutler W, Linovitz R, et al. Clinical experience using Cortoss for treating vertebral compression fractures with vertebroplasty and kyphoplasty: Twenty four-month followup. Spine (Phila Pa 1976) 2010;35:E1030–6.
Zhou JL, Liu SQ, Ming JH, Peng H, Qiu B. Comparison of therapeutic effect between percutaneous vertebroplasty and kyphoplasty on vertebral compression fracture. Chin J Traumatol 2008;11:42–4.
Movrin I, Vengust R, Komadina R. Adjacent vertebral fractures after percutaneous vertebral augmentation of osteoporotic vertebral compression fracture: A comparison of balloon kyphoplasty and vertebroplasty. Arch Orthop Trauma Surg 2010;130:1157–66.
Matthis C, Weber U, O’Neill TW, Raspe H. Health impact associated with vertebral deformities: Results from the European Vertebral Osteoporosis Study (EVOS). Osteoporos Int 1998;8:364–72.
Lieberman IH, Dudeney S, Reinhardt MK, Bell G. Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine (Phila Pa 1976) 2001;26:1631–8.
Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet 2002;359:1761–7.
Berlemann U, Franz T, Orler R, Heini PF. Kyphoplasty for treatment of osteoporotic vertebral fractures: A prospective non-randomized study. Eur Spine J 2004;13:496–501.
Garfin SR, Yuan HA, Reiley MA. New technologies in spine: Kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine (Phila Pa 1976) 2001;26:1511–5.
Schofer MD, Efe T, Timmesfeld N, Kortmann HR, Quante M. Comparison of kyphoplasty and vertebroplasty in the treatment of fresh vertebral compression fractures. Arch Orthop Trauma Surg 2009;129:1391–9.
Grohs JG, Matzner M, Trieb K, Krepler P. Minimal invasive stabilization of osteoporotic vertebral fractures: A prospective nonrandomized comparison of vertebroplasty and balloon kyphoplasty. J Spinal Disord Tech 2005;18:238–42.
Liu JT, Liao WJ, Tan WC, Lee JK, Liu CH, Chen YH, et al. Balloon kyphoplasty versus vertebroplasty for treatment of osteoporotic vertebral compression fracture: A prospective, comparative, and randomized clinical study. Osteoporos Int 2010;21:359–64.
Röllinghoff M, Siewe J, Zarghooni K, Sobottke R, Alparslan Y, Eysel P, et al. Effectiveness, security and height restoration on fresh compression fractures–A comparative prospective study of vertebroplasty and kyphoplasty. Minim Invasive Neurosurg 2009;52:233–7.
Lovi A, Teli M, Ortolina A, Costa F, Fornari M, Brayda-Bruno M. Vertebroplasty and kyphoplasty: Complementary techniques for the treatment of painful osteoporotic vertebral compression fractures. A prospective non-randomised study on 154 patients. Eur Spine J 2009;18 Suppl 1:95–101.
Barr JD, Barr MS, Lemley TJ, McCann RM. Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine (Phila Pa 1976) 2000;25:923–8.
Heini PF, Wälchli B, Berlemann U. Percutaneous transpedicular vertebroplasty with PMMA: Operative technique and early results. A prospective study for the treatment of osteoporotic compression fractures. Eur Spine J 2000;9:445–50.
Lin EP, Ekholm S, Hiwatashi A, Westesson PL. Vertebroplasty: Cement leakage into the disc increases the risk of new fracture of adjacent vertebral body. AJNR Am J Neuroradiol 2004;25:175–80.
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Shi-Ming, G., Wen-Juan, L., Yun-Mei, H. et al. Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for osteoporotic vertebral compression fracture. IJOO 49, 377–387 (2015). https://doi.org/10.4103/0019-5413.154892
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DOI: https://doi.org/10.4103/0019-5413.154892