Comparison of Clinical and Radiological Outcomes after Vertebroplasty and Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Vertebroplasty (VP) and balloon kyphoplasty (KP) are effective means with which to improve pain and function in osteoporotic vertebral compression fractures. However, the risk of complications after these procedures is poorly understood, with concerns regarding adjacent vertebral fractures. This study retrospectively investigated the clinical and radiological outcomes of these procedures. Methods: A total of 115 patients who experienced their first vertebral fracture were treated with VP (N=63) or KP (N=52) at the Dankook University Hospital between January 2013 and December 2022. The clinical outcomes were evaluated using the visual analog scale (VAS) preoperative and at 1-year follow-up. Radiological comparisons were performed for kyphosis correction, vertebral height restoration, and postoperative cement leakage. Results: KP was more effective than VP, especially for vertebral body height restoration and kyphotic angle reduction (P<0.05). However, the incidence of cement leakage, new adjacent vertebral fractures, and improvement in pain assessed by VAS did not differ statistically between the 2 groups (P>0.05). Conclusions: Considering that KP was performed on fractures with severe deformity, no differences were observed in the clinical outcomes and incidence of adjacent vertebral fractures compared Considering that KP was performed for fractures with severe deformity, there was no difference in clinical outcomes and incidence of adjacent vertebral fractures compared to VP. Improvements in radiological measurements were demonstrated. Therefore, KP may be a good treatment option for pain relief and long-term prognosis in patients with high-compressive-rate vertebral fractures.
Abstract
Background: Vertebroplasty (VP) and balloon kyphoplasty (KP) are effective means with which to improve pain and function in osteoporotic vertebral compression fractures. However, the risk of complications after these procedures is poorly understood, with concerns regarding adjacent vertebral fractures. This study retrospectively investigated the clinical and radiological outcomes of these procedures. Methods: A total of 115 patients who experienced their first vertebral fracture were treated with VP (N=63) or KP (N=52) at the Dankook University Hospital between January 2013 and December 2022. The clinical outcomes were evaluated using the visual analog scale (VAS) preoperative and at 1-year follow-up. Radiological comparisons were performed for kyphosis correction, vertebral height restoration, and postoperative cement leakage. Results: KP was more effective than VP, especially for vertebral body height restoration and kyphotic angle reduction (P<0.05). However, the incidence of cement leakage, new adjacent vertebral fractures, and improvement in pain assessed by VAS did not differ statistically between the 2 groups (P>0.05). Conclusions: Considering that KP was performed on fractures with severe deformity, no differences were observed in the clinical outcomes and incidence of adjacent vertebral fractures compared Considering that KP was performed for fractures with severe deformity, there was no difference in clinical outcomes and incidence of adjacent vertebral fractures compared to VP. Improvements in radiological measurements were demonstrated. Therefore, KP may be a good treatment option for pain relief and long-term prognosis in patients with high-compressive-rate vertebral fractures.
참고문헌 (29)
- Lindsay R, "One year outcomes and costs following a vertebral fracture", Osteoporos Int, 16, pp.78~85 (2005)[DOI]
- Felsenberg D, "Incidence of vertebral fracture in europe : results from the European Prospective Osteoporosis Study(EPOS)", J Bone Miner Res, 17, pp.716~724 (2002)[DOI]
- Buchbinder R, "A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures", N Engl J Med, 361, pp.557~568 (2009)[DOI]
- Liu JT, "Long-term follow-up study of osteoporotic vertebral compression fracture treated using balloon kyphoplasty and vertebroplasty", J Neurosurg Spine, 23, pp.94~98 (2015)[DOI]
- Griffoni C, "Percutaneous vertebroplasty and balloon kyphoplasty in the treatment of osteoporotic vertebral fractures : a prospective randomized comparison", Eur Spine J, 29, pp.1614~1620 (2020)[DOI]
- Lieberman IH, "Initial outcome and efficacy of"kyphoplasty"in the treatment of painful osteoporotic vertebral compression fractures", Spine(Phila Pa 1976), 26, pp.1631~1638 (2001)[DOI]
- Fribourg D, "Incidence of subsequent vertebral fracture after kyphoplasty", Spine(Phila Pa 1976), 29, pp.2270~2277 (2004)[DOI]
- Grados F, "Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty", Rheumatology(Oxford), 39, pp.1410~1414 (2000)[DOI]
- Kim SH, "Risk factors of new compression fractures in adjacent vertebrae after percutaneous vertebroplasty", Acta Radiol, 45, pp.440~445 (2004)[DOI]
- Kim MH, "Risk factors of new compression fractures in adjacent vertebrae after percutaneous vertebroplasty", Asian Spine J, 5, pp.180~187 (2011)[DOI]
- McKiernan F, "The dynamic mobility of vertebral compression fractures", J Bone Miner Res, 18, pp.24~29 (2003)[DOI]
- Movrin I, "Adjacent vertebral fractures after percutaneous vertebral augmentation of osteoporotic vertebral compression fracture : a comparison of balloon kyphoplasty and vertebroplasty", Arch Orthop Trauma Surg, 130, pp.1157~1166 (2010)[DOI]
- Hallberg I, "Health-related quality of life after osteoporotic fractures", Osteoporos Int, 15, pp.834~841 (2004)[DOI]
- Kado DM, "Hyperkyphotic posture and risk of injurious falls in older persons : the Rancho Bernardo Study", J Gerontol A Biol Sci Med Sci, 62, pp.652~657 (2007)[DOI]
- Lindsay R, "Risk of new vertebral fracture in the year following a fracture", JAMA, 285, pp.320~323 (2001)[DOI]
- Sinaki M, "Balance disorder and increased risk of falls in osteoporosis and kyphosis : significance of kyphotic posture and muscle strength", Osteoporos Int, 16, pp.1004~1010 (2005)[DOI]
- Svedbom A, "Balloon kyphoplasty compared to vertebroplasty and nonsurgical management in patients hospitalised with acute osteoporotic vertebral compression fracture : a UK cost-effectiveness analysis", Osteoporos Int, 24, pp.355~367 (2013)[DOI]
- Hopkins TJ, "Cost-effectiveness of balloon kyphoplasty and vertebroplasty versus conservative medical management in the USA", Osteoporos Int, 31, pp.2461~2471 (2020)[DOI]
- Shindle MK, "Vertebral height restoration in osteoporotic compression fractures : kyphoplasty balloon tamp is superior to postural correction alone", Osteoporos Int, 17, pp.1815~1819 (2006)[DOI]
- Wang H, "Comparison of percutaneous vertebroplasty and balloon kyphoplasty for the treatment of single level vertebral compression fractures : a meta-analysis of the literature", Pain Physician, 18, pp.209~222 (2015)
- Ma XL, "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, pp.1844~1859 (2012)[DOI]
- Zhao G, "Balloon kyphoplasty versus percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures(OVCFs)", Osteoporos Int, 27, pp.2823~2834 (2016)[DOI]
- Rho YJ, "Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty", Eur Spine J, 21, pp.905~911 (2012)[DOI]
- Lin EP, "Vertebroplasty : cement leakage into the disc increases the risk of new fracture of adjacent vertebral body", AJNR Am J Neuroradiol, 25, pp.175~180 (2004)
- Komemushi A, "Percutaneous vertebroplasty for osteoporotic compression fracture : multivariate study of predictors of new vertebral body fracture", Cardiovasc Intervent Radiol, 29, pp.580~585 (2006)[DOI]
- Hulme PA, "Vertebroplasty and kyphoplasty : a systematic review of 69 clinical studies", Spine(Phila Pa 1976), 31, pp.1983~2001 (2006)[DOI]
- Taylor RS, "Balloon kyphoplasty and vertebroplasty for vertebral compression fractures : a comparative systematic review of efficacy and safety", Spine(Phila Pa 1976), 31, pp.2747~2755 (2006)[DOI]
- Lee MJ, "Percutaneous treatment of vertebral compression fractures : a meta-analysis of complications", Spine(Phila Pa 1976), 34, pp.1228~1232 (2009)[DOI]
- Min SH, "Clinical results and efficacy of selective nerve root blocks with vertebroplasty in treatment of patients with osteoporotic compression fracture accompanied by spinal stenosis", J Korean Orthop Assoc, 49, pp.202~208 (2014)