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.
Spine Surgery Department III, IRCCS Galeazzi Orthopaedic Institute, Via Galeazzi 4, Milan 20161, Italy. alessio.lovi@libero.it
Alessio
A
Lovi
Marco
M
Teli
Alessandro
A
Ortolina
Francesco
F
Costa
Maurizio
M
Fornari
Marco
M
Brayda-Bruno
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