title: Comparison of high-viscosity cement vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures.
abstract: BACKGROUND
  Percutaneous vertebroplasty is a widely used vertebral augmentation procedure for treating osteoporotic vertebral compression fractures (OVCFs). But high cement leakage rate caused by a low-viscosity cement and high injection pressure has limited its general use. Balloon kyphoplasty (BKP) and high-viscosity cement vertebroplasty (HVCV) are 2 modifications of vertebroplasty designed to decrease cement leakage.
  
  
  OBJECTIVE
  To assess the safety and efficacy of HVCV compared with BKP.
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  Department of Spine Surgery, an affiliated hospital of a medical university.
  
  
  METHODS
  One hundred seven patients suffering from painful OVCFs were randomly assigned into HVCV or BKP groups. Visual Analog Scale (VAS), Oswestry Disability Index (ODI), cement leakage, and vertebral height restoration were evaluated. All occurring complications and injected cement volumes were recorded. The follow-up time was one year.
  
  
  RESULTS
  VAS and ODI scores improved in both groups, and did not differ significantly between the 2 groups. More cement was used in the BKP group than in HVCV group (4.22 vs. 3.31 mL, P < 0.0001). The incidence of cement leakage in the HVCV group was lower than that of the BKP group (13.24% vs 30.56%, P < 0.05). No symptomatic cement leakages occurred in the HVCV group. In the BKP group, one patient experienced discogenic back pain related to a disc leak, and another patient had asymptomatic cement emboli in the lung related to venous leakage. The mean compression rate before the procedure was 29.98% in the HVCV group and 28.67% in the BKP group (P = 0.94). The vertebral height was improved significantly and maintained at one-year follow-up in both groups. BKP was more effective in vertebral height restoration than HVCV (44.87% vs. 23.93%, P < 0.0001). There was one case of a new adjacent vertebral fracture in the HVCV group (2%), and 4 cases of new nonadjacent vertebral fractures in the BKP group (7.84%) (P = 0.18).
  
  
  CONCLUSIONS
  A single-center and relatively small-sample size study.
  
  
  CONCLUSIONS
  HVCV and BKP are safe and effective in improving quality of life and relieving pain. HVCV has a lower cement leakage rate, whereas BKP is more effective in vertebral height restoration. Subsequent fractures are not different between the 2 groups.
authors: Department of Spine Surgery, Qilu Hospital, Shandong University, P.R. China; Department of Orthopedics, Liaocheng People's Hospital, P.R. China; Department of Radiology, Liaocheng People's Hospital, Liaocheng, P.R. China.
authors: Cheng-hu
authors: CH
authors: Wang
authors: Jin-zhu
authors: JZ
authors: Ma
authors: Chuan-chen
authors: CC
authors: Zhang
authors: Lin
authors: L
authors: Nie
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000737:chemistry / Q000592:standards*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D058498:Kyphoplasty / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D010146:Pain / Q000000981:diagnostic imaging / Q000601:surgery; D010147:Pain Measurement / Q000379:methods; D011446:Prospective Studies; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods / Q000592:standards*; D014783:Viscosity
chemical_list: D001843:Bone Cements