Vertebroplasty and kyphoplasty: complementary techniques for the treatment of painful osteoporotic vertebral compression fractures. A prospective non-randomised study on 154 patients.
In a prospective study, we aimed to evaluate the potential use of kyphoplasty (KP) and vertebroplasty (VP) as complementary techniques in the treatment of painful osteoporotic vertebral compression fractures (VCFs). After 1 month of conservative treatment for VCFs, patients with intractable pain were offered treatment with KP or VP according to a treatment algorithm that considers time from fracture (Delta t) and amount of vertebral body collapse. Bone biopsy was obtained intra-operatively to exclude patients affected by malignancy or osteomalacia. 164 patients were included according to the above criteria. Mean age was 67.6 years. Mean follow-up was 33 months. 10 patients (6.1%) were lost to follow-up and 154 reached the minimum 2-year follow-up. 118 (69.5%) underwent VP and 36 (30.5%) underwent KP. Complications affected five patients treated with VP, whose one suffered a transient intercostal neuropathy and four a subsequent VCF (two at adjacent level). Results in terms of visual analogue scale and Oswestry scores were not different among treatment groups. In conclusion, at an average follow-up of almost 3 years from surgical treatment of osteoporotic VCFs, VP and KP show similar good clinical outcomes and appear to be complementary techniques with specific different indications.
Lovi
Alessio
A
Spine Surgery Department III, IRCCS Galeazzi Orthopaedic Institute, Via Galeazzi 4, Milan 20161, Italy. alessio.lovi@libero.it
Teli
Marco
M
Ortolina
Alessandro
A
Costa
Francesco
F
Fornari
Maurizio
M
Brayda-Bruno
Marco
M
D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001416:Back Pain / Q000209:etiology / Q000473:pathology / Q000601:surgery; D001706:Biopsy; D001859:Bone Neoplasms / Q000175:diagnosis; D002985:Clinical Protocols; D015331:Cohort Studies; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D018579:Patient Selection; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D012720:Severity of Illness Index; D016103:Spinal Fractures / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013995:Time; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods* / Q000706:statistics & numerical data