Balloon kyphoplasty versus percutaneous vertebroplasty for osteoporotic vertebral body compression fractures: clinical and radiological outcomes |
| |
| Institution: | 1. School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, Australia;2. Sydney Musculoskeletal Health, The University of Sydney, Camperdown, Sydney, Australia;3. Sydney Spine Institute, Burwood, Sydney, Australia;4. Neuro Spine Surgery Research Group (NSURG), Sydney, Australia;5. University of Oklahoma Medical Center, Oklahoma City, OK, USA;6. Discipline of Chiropractic, School of Health, Medical and Applied Sciences, CQUniversity, Brisbane, Queensland, Australia;7. University of Technology Sydney, Ultimo, Sydney, Australia;8. Liverpool Hospital, Liverpool, Sydney, Australia;9. Concord General Repatriation Hospital, Concord, Sydney, Australia;10. Faculty of Medicine, University of New South Wales, Sydney, Australia;11. Wearables and Gait Assessment Research Group [WAGAR], Sydney Australia;1. Clinic of Neurosurgery, Sv. Georgi University Hospital, Plovdiv, Bulgaria;2. Department of Anatomy, Histology and Embryology, Faculty of Medicine, Medical University of Plovdiv, Bulgaria;3. Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria;1. Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA;2. Harvard Combined Orthopaedic Residency Program, Boston, MA, USA;1. Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Ave, New Haven, CT, 06510, USA;2. Nuvasive Clinical Services, 10275 Little Patuxent Pkwy Ste 300, Columbia, MD 21044, USA;3. UConn Main Campus, 2131 Hillside Road, Unit 3088, Storrs, CT 06269-3088, USA |
| |
| Abstract: | BACKGROUND CONTEXTOsteoporotic 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.PURPOSEAim 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 DESIGNProspective cohort studyPATIENT SAMPLE40 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 MEASURESOperative 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.METHODSAll 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.RESULTThere 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 < .001There 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)CONCLUSIONOur 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. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
