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The Spine Journal : Official Journal of... Apr 2023Osteoporotic vertebral body compression fracture are the commonest fractures amongst the other osteoporotic fracture sites. These fragility fractures are the result of...
BACKGROUND CONTEXT
Osteoporotic vertebral body compression fracture are the commonest fractures amongst the other osteoporotic fracture sites. These fragility fractures are the result of low energy mechanical forces that that would not ordinarily result in fracture. Percutaneous vertebroplasty and balloon kyphoplasty has been widely used as minimally invasive procedures to treat painful vertebral compression fractures.
PURPOSE
Aim of the present study was to evaluate radiological, clinical and functional outcome of patients with osteoporotic vertebral body fractures treated with Balloon Kyphoplasty and Vertebroplasty.
STUDY DESIGN
Prospective cohort study PATIENT SAMPLE: 40 patients (Male:15, Female: 25) with average age of 56 +/- 8 years diagnosed with osteoporotic vertebral body compression fracture on clinical and radiological evaluation with no neurological deficit and no other associated fractures were included.
OUTCOME MEASURES
Operative time, cost for the procedure, gain in vertebral body height, reduction in pain, ability to perform daily routine activities, risk of cement leakage and any other systemic complications were evaluated and compared in both the study groups.
METHODS
All the patients underwent conventional Xray, MRI (to rule out acute from chronic fracture, to check compromise of spinal canal and calculate collapse in vertebral body height), Visual analog scaling for severity of pain and difficulty in daily routine activities by Oswestry disability index preoperatively. Post operative clinal, functional, radiological outcome and complications were compared in patients treated with percutaneous vertebroplasty and balloon kyphoplasty.
RESULT
There was significant difference in intraoperative time period and procedure cost for the patients treated with Vertebroplasty(50.75min, 25k) in comparison to balloon kyphoplasty (71.95, 50k) with p value being < .001 There was significant difference between preoperative and postoperative study parameters in both the study groups but there was no significant difference in post operative study parameters amongst both the study groups with p values >.05 for different parameters, 0.381(Gain in vertebral height), 0.108 (pain relief), 0.846(Oswestry disability index) and 0.197(risk of cement leakage) CONCLUSION: Our study suggested that percutaneous vertebroplasty requires less operative time and is more economical than balloon kyphoplasty. Increase in intraoperative time increases the risk of infection. Though the cases of Intraoperative operative cement leakage were more in percutaneous vertebroplasty but is was not significant. However the final radiological, clinical, functional outcome and overall complications were found to be similar in both the groups. Balloon kyphoplasty provided no added benefit over percutaneous vertebroplasty. A study with larger sample size will be needed to warrant one surgical procedure superior to other in the treatment of osteoporotic vertebral body compression fracture.
Topics: Humans; Male; Female; Middle Aged; Kyphoplasty; Osteoporotic Fractures; Fractures, Compression; Spinal Fractures; Prospective Studies; Vertebral Body; Treatment Outcome; Vertebroplasty; Pain; Bone Cements
PubMed: 36481681
DOI: 10.1016/j.spinee.2022.11.015 -
European Spine Journal : Official... Jul 2020The purpose of this study is to compare the efficacy and safety of percutaneous vertebroplasty (PVP) and balloon kyphoplasty (BKP) in the treatment of osteoporotic... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
The purpose of this study is to compare the efficacy and safety of percutaneous vertebroplasty (PVP) and balloon kyphoplasty (BKP) in the treatment of osteoporotic vertebral compression fractures.
MATERIALS AND METHODS
Patients with osteoporotic vertebral body fractures (T4-L5) were randomized and not blinded to kyphoplasty (n = 69) or vertebroplasty (n = 70). The postoperative pain score (VAS) at 12 months was the primary end point. The radiographic results were evaluated in relation to the resolution of the fracture and the possible onset of further osteoporotic fractures during follow-up.
RESULTS
A total of one hundred and thirty-nine patients were eligible for randomization (n = 70 for PVP group and n = 69 for BKP), and twenty-six patients (twenty in the BKP group and six in the PVP group) were excluded. The mean average age of patients was 73 years, and 82% of the patients were females. VAS pain score was significantly reduced after surgery in both groups, and there were no significant differences between the two groups in postoperative VAS score. There was a significant reduction in kyphotic wedge angle and improvement of the sagittal index in both groups, but there was no significant difference between the two groups. There was a significant higher risk incidence of adjacent level fractures in the vertebroplasty group.
CONCLUSIONS
In terms of clinical outcomes, there were no differences between the two groups. Both showed a significant clinical improvement, vertebral body height restoration and reduction in the kyphotic angle. There was a significant higher risk of adjacent level fractures in the vertebroplasty group.
Topics: Aged; Female; Fractures, Compression; Humans; Kyphoplasty; Male; Osteoporotic Fractures; Prospective Studies; Spinal Fractures; Treatment Outcome; Vertebroplasty
PubMed: 32361843
DOI: 10.1007/s00586-020-06434-3 -
Revista Clinica Espanola 2021
Topics: Embolism; Humans; Pulmonary Embolism; Vertebroplasty
PubMed: 34332705
DOI: 10.1016/j.rceng.2021.03.001 -
BMC Musculoskeletal Disorders Aug 2022The study objective was to compare the efficacy and safety of percutaneous vertebroplasty (PVP) combined with facet joint block (FB) and vertebroplasty alone in... (Randomized Controlled Trial)
Randomized Controlled Trial
Vertebroplasty combined with facet joint block vs. vertebroplasty alone in relieving acute pain of osteoporotic vertebral compression fracture: a randomized controlled clinical trial.
OBJECTIVE
The study objective was to compare the efficacy and safety of percutaneous vertebroplasty (PVP) combined with facet joint block (FB) and vertebroplasty alone in relieving acute pain on osteoporotic vertebral compression fractures (OVCFs).
METHODS
A prospective, randomized controlled study was conducted. One hundred ninety-eight patients of OVCFs undergoing surgery were randomly divided into two groups: Group P (PVP, n = 97), Group PF (PVP + FB, n = 101). The Visual analogue scale (VAS) and Oswestry disability index (ODI) were measured during pre-operation, 1 day, 1, 3, 6 and 12 months after the operation, respectively. The hospitalization time, operation time, complications, recurrence, the mean amount of cement injected and the number of patients who applied Cox-2 inhibitors within 3 days after operation were compared in the two groups.
RESULTS
The VAS and ODI scores at each observation point of the post-operation were significantly decreased than that at the pre-operation in both groups (P < 0.05). The VAS and ODI scores in Group PF were significantly lower than that in Group P 1 day and 1 month after the operation (P < 0.05). The number of patients who applied Cox-2 inhibitors within 3 days after operation in group PF was significantly lower that in Group P (P < 0.001). There was no significant difference in hospitalization time, operation time, the mean amount of cement injected, complication rate, VAS and ODI scores at the pre-operation (P > 0.05).
CONCLUSION
Both PVP combined with FB and PVP alone are effective treatment methods for OVCFs. But PVP combined with FB showed better back pain relief than PVP alone in the short term after the operation for OVCFs.
Topics: Acute Pain; Bone Cements; Cyclooxygenase 2 Inhibitors; Fractures, Compression; Humans; Osteoporotic Fractures; Prospective Studies; Retrospective Studies; Spinal Fractures; Treatment Outcome; Vertebroplasty; Zygapophyseal Joint
PubMed: 35999526
DOI: 10.1186/s12891-022-05753-4 -
Clinical Privilege White Paper Dec 2011
Topics: Credentialing; Education, Medical, Graduate; Fractures, Compression; Humans; Joint Commission on Accreditation of Healthcare Organizations; Medical Staff Privileges; Orthopedics; Societies, Medical; United States; Vertebroplasty
PubMed: 22111112
DOI: No ID Found -
La Revue Du Praticien Sep 2019
Topics: Humans; Kyphoplasty; Osteoporotic Fractures; Spinal Fractures; Vertebroplasty
PubMed: 32233308
DOI: No ID Found -
Aging Clinical and Experimental Research Apr 2011Kyphoplasty and vertebroplasty are minimally invasive techniques to treat vertebral compression fractures, now considered as implying relative risks and being equally... (Review)
Review
Kyphoplasty and vertebroplasty are minimally invasive techniques to treat vertebral compression fractures, now considered as implying relative risks and being equally effective. A few considerations must anyway be made due to some unresolved problems.
Topics: Biomarkers; Bone Density Conservation Agents; Bone Resorption; Bone and Bones; Diphosphonates; Disease Progression; Humans; Kyphoplasty; Osteoporosis; Quality of Life; Treatment Outcome; Vertebroplasty
PubMed: 21970921
DOI: No ID Found -
Skeletal Radiology Oct 2023Vertebral compression fractures (VCFs) are a common pathologic process seen in 30-50% of individuals over the age of 50 years. Historically, VCFs were first treated... (Review)
Review
Vertebral compression fractures (VCFs) are a common pathologic process seen in 30-50% of individuals over the age of 50 years. Historically, VCFs were first treated with nonsurgical management while vertebral augmentation was reserved for severe cases resulting in deformity or significant disability. Current treatment algorithms based on established appropriateness criteria have changed recommendations towards supporting early vertebral augmentation for the VCFs causing the most clinically difficulty and taking into account the degree of vertebral body height loss, kyphotic deformity, and the degree of clinical progression. Percutaneous vertebroplasty (PVP) involves injecting primarily polymethacrylate (PMMA) bone cement directly into the cancellous bone of the vertebral body. There is recent literature showing the effectiveness of PVP including data comparing vertebroplasty to sham treatment. Vertebroplasty evolved into balloon kyphoplasty (BKP) where a balloon is first inserted into the vertebral body to create a cavity and reduce the fracture followed by an injection of bone cement. Both PVP and BKP have been shown to be significantly more effective at treatment of VCFs compared to nonsurgical management. The benefits shown in the literature have been demonstrated randomized control trials, cohort matched trials, post-market trials, registries, and many other data sources with approximately 250 manuscripts produced per year dedicated to the topic of vertebral augmentation.
Topics: Humans; Middle Aged; Bone Cements; Bone Diseases, Metabolic; Fractures, Compression; Kyphoplasty; Osteoporotic Fractures; Spinal Fractures; Treatment Outcome; Vertebroplasty
PubMed: 35761093
DOI: 10.1007/s00256-022-04092-8 -
World Neurosurgery Jul 2016
Topics: Bone Cements; Fractures, Compression; Humans; Kyphoplasty; Osteoporosis; Osteoporotic Fractures; Spinal Fractures; Spine; Treatment Outcome; Vertebroplasty
PubMed: 27072339
DOI: 10.1016/j.wneu.2016.04.016 -
Journal of Neurosurgery. Spine Nov 2009
Topics: Humans; Osteoporosis; Postoperative Complications; Spinal Fractures; Vertebroplasty
PubMed: 19929365
DOI: 10.3171/2009.6.SPINE09359