title: Is balloon kyphoplasty better than percutaneous vertebroplasty for osteoporotic vertebral biconcave-shaped fractures?
abstract: BACKGROUND
  Osteoporotic vertebral biconcave-shaped fractures are not commonly seen in clinical practice. Some articles have been published showing the outcome of vertebroplasty (PV) and balloon kyphoplasty (BKP), but few comparative studies have been performed.
  
  
  OBJECTIVE
  To compare the effect and safety of PV and BKP in treating osteoporotic vertebral biconcave-shaped fractures.
  
  
  METHODS
  In this retrospective comparative study, 38 patients with osteoporotic vertebral biconcave-shaped fractures were treated by PV, and 41 patients were treated by BKP from May 2005 to July 2011. The heights of the compromised vertebral body and the kyphotic angles were measured. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate pain and functional activity, respectively. The occurrence of refracture and cement leakage were determined, and the costs were recorded.
  
  
  RESULTS
  The mean VAS and ODI scores significantly improved for both procedures at postsurgical measurements (P < 0.05), and the improvement sustained at the final follow-up. In both groups, there were no significant differences in terms of restoration of the anterior vertebral height and correction of the kyphotic deformity. However, BKP was more effective in restoring the middle vertebral height than PV. Cement leakages were observed in nine (23.7%) treated vertebral bodies in PV group and in three (7.4%) treated vertebral bodies in BKP group, which was a statistically significant difference (P < 0.05). There were four new osteoporotic vertebral fractures in the PV group and two in the BKP group during the follow-up period. The mean cost in the BKP group (6200 ± 122.1 USD) was higher than the PV group (2100 ± 112.5 USD) (P < 0.05).
  
  
  CONCLUSIONS
  Both PV and BKP achieved similar improvements in pain and functional outcomes for the treatment of osteoporotic vertebral biconcave-shaped fractures. BKP had a significant advantage over PV in terms of the restoration of the middle vertebral height and fewer cement leakages than PV.
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, PR China.
authors.forename: Minfeng
authors.initials: M
authors.lastname: Gan
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, PR China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zou
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, PR China.
authors.forename: Dawei
authors.initials: D
authors.lastname: Song
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, PR China.
authors.forename: Xuesong
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, PR China.
authors.forename: Genlin
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, PR China yhlpaper@126.com.
authors.forename: Huilin
authors.initials: H
authors.lastname: Yang
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058498:Kyphoplasty / Q000379:methods / Q000592:standards; D008297:Male; D058866:Osteoporotic Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement / Q000379:methods; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods* / Q000592:standards*
keywords: Percutaneous vertebroplasty; balloon kyphoplasty; osteoporosis; osteoporotic vertebral biconcave-shaped fractures