title: Kyphoplasty versus vertebroplasty in osteoporotic thoracolumbar spine fractures. Short-term retrospective review of a multicentre cohort of 127 consecutive patients.
abstract: BACKGROUND
  Osteoporotic spine fractures induce a heavy burden in terms of both general health and healthcare costs. The objective of this multicentre study by the French Society for Spine Surgery (SFCR) was to compare outcomes after vertebroplasty and kyphoplasty in the treatment of osteoporotic thoracolumbar vertebral fractures.
  
  
  OBJECTIVE
  We hypothesised that differences existed between vertebroplasty and kyphoplasty, notably regarding operative time and reduction efficacy, from which criteria for patient selection might be inferred.
  
  
  METHODS
  We conducted a retrospective multicentre review of 127 patients with Magerl Type A low-energy fractures after a fall from standing height between 2007 and 2010; 85 were managed with vertebroplasty and 42 with kyphoplasty. Age was not a selection criterion. We recorded pain intensity, time to management, operative time, kyphosis angle, wedge angle, cement leakage rate, and degree of cement filling.
  
  
  RESULTS
  Operative time was 43 minutes with kyphoplasty and 24 minutes with vertebroplasty (P=0.0002). Both techniques relieved pain, with no significant difference. Kyphoplasty significantly improved the wedge angle, by +6°, versus +2° with vertebroplasty (P=0.002). With kyphoplasty, the volume injected was larger and cement distribution was less favourable. Leakage rates were similar.
  
  
  CONCLUSIONS
  Despite the heterogeneity of our study, our data confirm the effectiveness of kyphoplasty in alleviating pain and decreasing deformities due to osteoporotic vertebral fractures. Vertebroplasty is a faster and less costly procedure that remains useful; no detectable clinical complications occur with vertebroplasty, which ensures better anchoring of the cement in the cancellous bone.
authors.affiliation: Academic Orthopaedics and Trauma Surgery Unit, Michallon Hospital, 38043 Grenoble Cedex 09, France. LGarnier1@chu-grenoble.fr
authors.forename: L
authors.initials: L
authors.lastname: Garnier
authors.forename: J
authors.initials: J
authors.lastname: Tonetti
authors.forename: A
authors.initials: A
authors.lastname: Bodin
authors.forename: H
authors.initials: H
authors.lastname: Vouaillat
authors.forename: P
authors.initials: P
authors.lastname: Merloz
authors.forename: R
authors.initials: R
authors.lastname: Assaker
authors.forename: C
authors.initials: C
authors.lastname: Court
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D058498:Kyphoplasty / Q000009:adverse effects / Q000379:methods; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D061646:Operative Time; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D056888:Patient Positioning; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000009:adverse effects / Q000379:methods*