Abstract
One of the current standard treatment options for younger patients with stable traumatic vertebral fractures is conservative treatment using braces. Kyphoplasty as a minimally invasive procedure has been shown to be effective in stabilizing vertebral body fractures, resulting in immediate pain relief and improved physical function. The purpose of this prospective study was to clarify whether patients with acute traumatic vertebral fractures benefit more from kyphoplasty or from conservative treatment with a brace. A prospective study was undertaken in two centers. Forty patients with acute painful traumatic vertebral body fractures type A1–A3 (AO-classification) after adequate trauma, without osteoporosis, suitable for kyphoplasty or therapy by brace were included into the study. Follow-up was 12 months. Patients of the kyphoplasty group showed an immediate beneficial and significant effect postoperatively, and better outcomes 1 and 3 months after operation compared to the conservatively treated group in pain feeling, mobility and vertebral body height. After 12 months the difference between both groups was not significant excepting the vertebral body height. Kyphoplasty provides early and lasting reduction of pain and improvement of daily activity. However, there are clinically asymptomatic cement leakages in up to 45% of which we do not know the consequences in long term. Every patient with traumatic vertebral body fracture treated by kyphoplasty has to be informed about that. Long-time results are outstanding and our findings require confirmation by randomized controlled trials.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Atalay B, Caner H, Gokce C, Altinors N (2005) Kyphoplasty: 2 years of experience in a neurosurgery department. Surg Neurol 64(2):72–76. doi:10.1016/j.surneu.2005.07.039
Braun W, Markmiller M, Ruter A (1991) Conservative therapy of fractures of the thoracic and lumbar spine Indications, treatment regimen, results. Chirurg 62:404408
DaFonseca K, Baier M, Grafe I, Libicher M, Noeldge G, Kasperk C et al (2006) Balloon kyphoplasty in the therapy of vertebral fractures. Orthopade 35(10):1101–1109. doi:10.1007/s00132-006-1005-z
Ettinger B, Black DM, Nevitt MC, Rundle AC, Cauley JA, Cummings SR et al (1992) Contribution of vertebral deformities to chronic back pain and disability The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 7:449456
Jarvik JG, Kallmes DF, Deyo RA (2006) Point of view: Kyphoplasty: more answers more questions? Spine 1 31(1):65–66
Kasperk C, Hillmeier J, Nöldge G, Grafe IA, Da Fonseca K, Raupp D et al (2005) Treatment of painful vertebral fractures by Kyphoplasty with primary osteoporosis: a prospective nonrandomized controlled study. JBMR 20:604–613. doi:10.1359/JBMR.041203
Knop C, Oeser M, Bastian L, Zdichavsky M, Blauth M (2001) Development and validation of the VAS spine score. Unfallchirurg 104:48–497
Libicher M, Hillmeier J, Liegibel U, Sommer U, Pyerin W, Vetter M, et al. (2006) Osseous integration of calcium phosphate in osteoporotic vertebral fractures after kyphoplasty: initial results from a clinical and experimental pilot study. Osteoporos Int
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 26:16311638. doi:10.1097/00007632-200107150-00026
Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB et al (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285:320323. doi:10.1001/jama.285.3.320
Lin JT, Lane JM (2002) Nonmedical management of osteoporosis. Curr Opin Rheumatol 14:441446. doi:10.1097/00002281-200207000-00019
Lips P, Cooper C, Agnusdei D, Caulin F, Egger P, Johnell O et al (1999) Quality of life in patients with vertebral fractures: Validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Working Party for Quality of Life of the European Foundation for Osteoporosis. Osteoporos Int 10:15016. doi:10.1007/s001980050210
Patwardhan AG, Li SP, Gavin T, Lorenz M, Meade KP, Zindrick M (1990) Orthotic stabilization of thoracolumbar injuries. A biomechanical analysis of the Jewett hyperextension orthosis. Spine 15:654661. doi:10.1097/00007632-199007000-00008
Pfeifer M, Begerow B, Minne H (2004) Effects of a new spinal orthosis on posture, trunk strength, and quality of women with postmenopausal osteoporosis: A randomized trial. Am J Phys Med Rehabil 83:177186. doi:10.1097/01.PHM.0000113403.16617.93
Taylor RS, Fritzell P, Taylor RJ (2007) Ballon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis. Eur Spine J 16(8):1085–1100
Voggenreiter G (2005) Baloon kyphoplasty is effective in deformity correction of osteoporotic vertebral compression fractures. Spine 30(24):2806–2812
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Schmelzer-Schmied, N., Cartens, C., Meeder, P.J. et al. Comparison of kyphoplasty with use of a calcium phosphate cement and non-operative therapy in patients with traumatic non-osteoporotic vertebral fractures. Eur Spine J 18, 624–629 (2009). https://doi.org/10.1007/s00586-008-0880-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-008-0880-x