title: Comparison of kyphoplasty and vertebroplasty for treatment of painful osteoporotic vertebral compression fractures: twelve-month follow-up in a prospective nonrandomized comparative study.
abstract: METHODS
  A prospective nonrandomized comparative study.
  
  
  OBJECTIVE
  To compare the efficacy and safety of kyphoplasty and vertebroplasty for treatment of painful osteoporotic vertebral compression fractures (VCFs) with respect to pain, functional outcome, radiomorphology, cement leakage, and incidence of new adjacent vertebral fracture.
  
  
  BACKGROUND
  Kyphoplasty and vertebroplasty have become common treatments for painful osteoporotic VCFs. Although the benefits of either kyphoplasty or vertebroplasty compared with conservative treatment have been frequently discussed, few clinical studies are available that directly compare the 2 procedures.
  
  
  METHODS
  Ninety-six patients with painful osteoporotic VCFs less than 4 weeks old were included and nonrandomly assigned to undergo kyphoplasty or vertebroplasty treatment. Clinical outcomes were assessed using the visual analog scale and the Oswestry Disability Index. Plain radiographs were analyzed to quantify spinal deformity correction (vertebral body height and kyphotic angle), and evaluate cement leakage and new adjacent vertebral fractures. The follow-up time was 12 months.
  
  
  RESULTS
  The baseline clinical and radiological characteristics of both groups were comparable. There were no significant differences between the 2 groups with regard to improvement in pain and functional scores at all postoperative intervals. Vertebral height restoration and kyphotic angle reduction were achieved in both groups, but the correction of spinal deformity was more significant in the kyphoplasty group. Asymptomatic cement leakage occurred in 9.1% and 34.6% of treated vertebrae for the kyphoplasty and vertebroplasty groups, respectively. Three adjacent fractures in the kyphoplasty group and 2 in the vertebroplasty group were identified during the follow-up time, and no major adverse events were observed.
  
  
  CONCLUSIONS
  Kyphoplasty and vertebroplasty demonstrated similar good clinical outcomes during the 12-month follow-up. Kyphoplasty offers a higher degree of spinal deformity correction and results in less cement leakage than vertebroplasty. The benefits of these relative merits need to be ascertained in future long-term studies.
authors.affiliation: Department of Orthopaedic Surgery, First Affiliated Hospital of Suzhou University, Shizi Street 188, Suzhou, China.
authors.forename: Xigong
authors.initials: X
authors.lastname: Li
authors.forename: Huilin
authors.initials: H
authors.lastname: Yang
authors.forename: Tiansi
authors.initials: T
authors.lastname: Tang
authors.forename: Zhonglai
authors.initials: Z
authors.lastname: Qian
authors.forename: Liang
authors.initials: L
authors.lastname: Chen
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D058498:Kyphoplasty / Q000379:methods*; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000628:therapy*; D016103:Spinal Fractures / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome