Abstract
Purpose
To evaluate the effect of vertebroplasty with a bone filler device compared with balloon kyphoplasty.
Methods
A total of 222 patients underwent operations from January 2008 to October 2012. One-level fractures numbered 169 (86.7 %) cases and two-level fractures numbered 26 (13.3 %). A total of 221 vertebral levels were analyzed consequently. Vertebral height, compression ratio, and segmental Cobb’s angle were measured in preoperative and postoperative lateral X-rays.
Results
The compression ratio was the most influential parameter among three variables. Adjusted postoperative compression ratio was not significantly different between two operation groups. Bone cement leakage rates did not differ (p < 0.05). Bone cement distribution was spongy type in the majority of the vertebroplasty with bone filler device (94.5 %), but only in 42.0 % of the kyphoplasty. High bone densitometry readings and long period from diagnosis to operation were significant risk factors for bone cement leakage.
Conclusions
Vertebroplasty with a bone filler device could achieve equivalent compression reduction and bone cement leakage rate, as well as greater sponge-type bone cement distribution, which were advantages over balloon kyphoplasty.
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References
Wardlaw D, Cummings SR, Van Meirhaeghe J, Bastian L, Tillman JB, Ranstam J, Eastell R, Shabe P, Talmadge K, Boonen S (2009) Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet 373(9668):1016–1024. doi:10.1016/S0140-6736(09)60010-6
Voormolen MH, Mali WP, Lohle PN, Fransen H, Lampmann LE, van der Graaf Y, Juttmann JR, Jansssens X, Verhaar HJ (2007) Percutaneous vertebroplasty compared with optimal pain medication treatment: short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures. The VERTOS study. AJNR Am J Neuroradiol 28(3):555–560
Hiwatashi A, Westesson PL, Yoshiura T, Noguchi T, Togao O, Yamashita K, Kamano H, Honda H (2009) Kyphoplasty and vertebroplasty produce the same degree of height restoration. AJNR Am J Neuroradiol 30(4):669–673. doi:10.3174/ajnr.A1442
Pradhan BB, Bae HW, Kropf MA, Patel VV, Delamarter RB (2006) Kyphoplasty reduction of osteoporotic vertebral compression fractures: correction of local kyphosis versus overall sagittal alignment. Spine (Phila Pa 1976) 31(4):435–441. doi:10.1097/01.brs.0000200036.08679.1e
Teng MM, Wei CJ, Wei LC, Luo CB, Lirng JF, Chang FC, Liu CL, Chang CY (2003) Kyphosis correction and height restoration effects of percutaneous vertebroplasty. AJNR Am J Neuroradiol 24(9):1893–1900
Hiwatashi A, Sidhu R, Lee RK, deGuzman RR, Piekut DT, Westesson PL (2005) Kyphoplasty versus vertebroplasty to increase vertebral body height: a cadaveric study. Radiology 237(3):1115–1119. doi:10.1148/radiol.2373041654
Kim KH, Kuh SU, Chin DK, Jin BH, Kim KS, Yoon YS, Cho YE (2012) Kyphoplasty versus vertebroplasty: restoration of vertebral body height and correction of kyphotic deformity with special attention to the shape of the fractured vertebrae. J Spinal Disord Tech 25(6):338–344. doi:10.1097/BSD.0b013e318224a6e6
Papanastassiou ID, Phillips FM, Van Meirhaeghe J, Berenson JR, Andersson GB, Chung G, Small BJ, Aghayev K, Vrionis FD (2012) Comparing effects of kyphoplasty, vertebroplasty, and non-surgical management in a systematic review of randomized and non-randomized controlled studies. Eur Spine J 21(9):1826–1843. doi:10.1007/s00586-012-2314-z
Ma XL, Xing D, Ma JX, Xu WG, Wang J, Chen Y (2012) Balloon kyphoplasty versus percutaneous vertebroplasty in treating osteoporotic vertebral compression fracture: grading the evidence through a systematic review and meta-analysis. Eur Spine J 21(9):1844–1859. doi:10.1007/s00586-012-2441-6
Tanigawa N, Komemushi A, Kariya S, Kojima H, Shomura Y, Omura N, Sawada S (2007) Relationship between cement distribution pattern and new compression fracture after percutaneous vertebroplasty. AJR Am J Roentgenol 189(6):W348–W352. doi:10.2214/AJR.07.2186
Kim KH, Kuh SU, Park JY, Kim KS, Chin DK, Cho YE (2012) What is the importance of “halo” phenomenon around bone cement following vertebral augmentation for osteoporotic compression fracture? Osteoporos Int 23(10):2559–2565. doi:10.1007/s00198-012-1896-y
Oka M, Matsusako M, Kobayashi N, Uemura A, Numaguchi Y (2005) Intravertebral cleft sign on fat-suppressed contrast-enhanced MR: correlation with cement distribution pattern on percutaneous vertebroplasty. Acad Radiol 12(8):992–999. doi:10.1016/j.acra.2005.05.003
Heini PF, Orler R (2004) Kyphoplasty for treatment of osteoporotic vertebral fractures. Eur Spine J 13(3):184–192. doi:10.1007/s00586-003-0654-4
Keynan O, Fisher CG, Vaccaro A, Fehlings MG, Oner FC, Dietz J, Kwon B, Rampersaud R, Bono C, France J, Dvorak M (2006) Radiographic measurement parameters in thoracolumbar fractures: a systematic review and consensus statement of the spine trauma study group. Spine (Phila Pa 1976) 31(5):E156–E165. doi:10.1097/01.brs.0000201261.94907.0d
Rho YJ, Choe WJ, Chun YI (2012) Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty. Eur Spine J 21(5):905–911. doi:10.1007/s00586-011-2099-5
Molloy S, Riley LH 3rd, Belkoff SM (2005) Effect of cement volume and placement on mechanical-property restoration resulting from vertebroplasty. AJNR Am J Neuroradiol 26(2):401–404
Ryu KS, Park CK, Kim MC, Kang JK (2002) Dose-dependent epidural leakage of polymethylmethacrylate after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures. J Neurosurg 96(1 Suppl):56–61
Nieuwenhuijse MJ, Bollen L, van Erkel AR, Dijkstra PD (2012) Optimal intravertebral cement volume in percutaneous vertebroplasty for painful osteoporotic vertebral compression fractures. Spine (Phila Pa 1976) 37(20):1747–1755. doi:10.1097/BRS.0b013e318254871c
Nieuwenhuijse MJ, Van Erkel AR, Dijkstra PD (2011) Cement leakage in percutaneous vertebroplasty for osteoporotic vertebral compression fractures: identification of risk factors. Spine J 11(9):839–848. doi:10.1016/j.spinee.2011.07.027
Ha KY, Lee JS, Kim KW, Chon JS (2006) Percutaneous vertebroplasty for vertebral compression fractures with and without intravertebral clefts. J Bone Joint Surg Br 88(5):629–633. doi:10.1302/0301-620X.88B5.17345
Shapiro S, Abel T, Purvines S (2003) Surgical removal of epidural and intradural polymethylmethacrylate extravasation complicating percutaneous vertebroplasty for an osteoporotic lumbar compression fracture. Case report. J Neurosurg 98(1 Suppl):90–92
Watts NB, Harris ST, Genant HK (2001) Treatment of painful osteoporotic vertebral fractures with percutaneous vertebroplasty or kyphoplasty. Osteoporos Int 12(6):429–437
Schmidt R, Cakir B, Mattes T, Wegener M, Puhl W, Richter M (2005) Cement leakage during vertebroplasty: an underestimated problem? Eur Spine J 14(5):466–473. doi:10.1007/s00586-004-0839-5
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Yang, DH., Cho, K.H., Chung, Y.S. et al. Effect of vertebroplasty with bone filler device and comparison with balloon kyphoplasty. Eur Spine J 23, 2718–2725 (2014). https://doi.org/10.1007/s00586-014-3379-7
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DOI: https://doi.org/10.1007/s00586-014-3379-7