Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies.
METHODS
Systematic literature review.


OBJECTIVE
To evaluate the safety and efficacy of vertebroplasty and kyphoplasty using the data presented in published clinical studies, with respect to patient pain relief, restoration of mobility and vertebral body height, complication rate, and incidence of new adjacent vertebral fractures.


BACKGROUND
Vertebroplasty and kyphoplasty have been gaining popularity for treating vertebral fractures. Current reviews provide an overview of the procedures but are not comprehensive and tend to rely heavily on personal experience. This article aimed to compile all available data and evaluate the clinical outcome of the 2 procedures.


METHODS
This is a systematic review of all the available data presented in peer-reviewed published clinical trials. The methodological quality of included studies was evaluated, and data were collected targeting specific standard measurements. Where possible, a quantitative aggregation of the data was performed.


RESULTS
A large proportion of subjects had some pain relief, including 87% with vertebroplasty and 92% with kyphoplasty. Vertebral height restoration was possible using kyphoplasty (average 6.6 degrees ) and for a subset of patients using vertebroplasty (average 6.6 degrees ). Cement leaks occurred for 41% and 9% of treated vertebrae for vertebroplasty and kyphoplasty, respectively. New fractures of adjacent vertebrae occurred for both procedures at rates that are higher than the general osteoporotic population but approximately equivalent to the general osteoporotic population that had a previous vertebral fracture.


CONCLUSIONS
The problem with stating definitely that vertebroplasty and kyphoplasty are safe and effective procedures is the lack of comparative, blinded, randomized clinical trials. Standardized evaluative methods should be adopted.
Hulme
Paul A
PA
M.E. Müller Institute for Surgical Technology and Biomechanics, Bern, Switzerland. Paul.Hulme@MEMcenter.unibe.ch
Krebs
Jörg
J
Ferguson
Stephen J
SJ
Berlemann
Ulrich
U
D006801:Humans; D015994:Incidence; D007738:Kyphosis / Q000503:physiopathology / Q000601:surgery*; D019637:Orthopedic Procedures / Q000009:adverse effects; D010166:Palliative Care; D016103:Spinal Fractures / Q000453:epidemiology / Q000209:etiology; D013131:Spine / Q000601:surgery*; D016896:Treatment Outcome