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Similar outcomes seen with vertebroplasty vs. kyphoplasty for osteoporotic vertebral compression fractures
Although outcomes were similar, balloon kyphoplasty reportedly resulted in less cement leakage.
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COPENHAGEN, Denmark — A comparison of balloon kyphoplasty with vertebroplasty has shown that both methods are safe and effective for the treatment of pain and disability associated with osteoporotic vertebral compression fractures, according to a recent presentation.
“Osteoporosis with subsequent vertebral compression fracture is an increasingly important disease due not only to its significant economic impact but also the increasing age of our population,” Dimitrios D. Nikolopoulos, MD, said at the 12th EFORT Congress 2011 here. “Our objective was to compare the efficacy and safety of balloon kyphoplasty and vertebroplasty for the treatment of vertebral compression fractures.”
Study methods and parameters
Nikolopoulos and his group investigated 142 patients aged 54 years to 84 years old who were treated for at total of 185 osteoporotic vertebral fractures of the thoracic or lumbar spine from January 2004 to December 2009. To be included in the study, patients had to report back pain for 8 weeks or more, with Visual Analog Scale (VAS) scores of 5 or more.
“The clinical evaluation was based on pain before and after treatment, with the use of the visual analogue scale and the Oswestry Disability Index (ODI), which was used to evaluate functional activity both before the procedure and 6 months later,” Nikolopoulos said.
Nikolopoulos reported 22 patients with 29 fractures were lost to follow-up. The remaining patients were randomly allocated to treatment, with 64% receiving percutaneous kyphoplasty and 36% receiving vertebroplasty. The team paid specific attention to sagittal alignment improvements and evaluated patients using the VAS and ODI scores. Postoperative radiographs were taken at 1-month, 3-months, 6-months and 12-months follow-up.
Both procedures significantly improved patients’ pain scores, ability to independently ambulate and decreased their reliance upon medications, Nikolopoulos said. Preoperative and postoperative VAS scores were similar for the groups.
Although Nikolopoulous noted vertebral body height and kyphotic wedge angle improvements for both groups, he added that kyphosis correction appeared to improve more with kyphoplasty than with vertebroplasty.
Cement leakage
Leakage rate was 12% for kyphoplasty and 32% for vertebroplasty. He added, however, that most of the leakage was clinically asymptomatic and both procedures displayed a low rate of serious complications. Both groups demonstrated new fracture rates of approximately 15% in the following 6 months.
“When we compared these two groups, no significant differences could be found between scores,” Nikolopoulos said. “Balloon kyphoplasty and vertebroplasty provided a safe and effective treatment for pain and disability in this cohort.”
“Balloon kyphoplasty led to an ongoing reduction of fractured vertebrae, and was followed by a lower rate of cement leakage,” he added. – by Robert Press
Reference:
- Nikolopoulos DD, Sergides N, Safos G, et al. Percutaneous balloon kyphoplasty and vertebroplasty for osteoporotic vertebral compression fractures: A systematic review of efficacy and safety. Paper #1052. Presented at the 12th EFORT Congress 2011. June 1-4. Copenhagen, Denmark.
- Dimitrios D. Nikolopoulos, MD, can be reached at the Central Clinic of Athens, Orthopaedic Department, Surgical Department of Thorax and Vascular Surgery, Asklepiou 31 str, Athens, 106-80, Greece; email: drdnikol@hotmail.com.
- Disclosure: Nikolopoulos has no relevant financial disclosures.