Does Percutaneous Kyphoplasty Have Better Functional Outcome Than Vertebroplasty in Single Level Osteoporotic Compression Fractures? A Comparative Prospective Study
Purpose. To evaluate the relative differences in surgical outcome of kyphoplasty (KP) versus vertebroplasty (VP) in the patients with single level refractory osteoporotic compression fractures (OCFs). Method. From August 2008 to May 2012, we intermittently treated 57 patients with single level OCF by PV and KP (Groups A and B, resp.). We used visual analogue scale (VAS) and short form 36 (SF36) questionnaire to measure functional recovery and followed them for six months. Independent samples t- and Kendall’s tau-b tests were for statistics. Results. In terms of age, number, and bone mineral density of the patients, there were no significant differences between the two groups. In both groups, VAS and SF-36 scores improved significantly and remained relatively stable throughout the follow-up period. We had 9 and 6 asymptomatic cement extravasations and 5 and 8 new vertebral fractures in Group A and B, respectively. In comparing the two groups, the results indicated that KP almost failed to show any significant higher effect relative to VP during this period. Conclusions. In considering the high cost of KP relative to VP in the developing countries like Iran, there is no logical reason to use KP in a single level refractory OCF in these regions. 1. Introduction Osteoporotic compression fractures (OCFs) are common debilitating entities that cause a variety of consequences in the elderly patients. Although two-third of them gradually improve with conservative treatment [1], intractable pain, decreased self-esteem, senile kyphosis, early satiety, mood disorder, and even increased mortality have been frequently reported [2–5]. Today vertebral augmentation procedures (vertebroplasty (VP) and kyphoplasty (KP)) are commonly used in the treatment of otherwise unmanageable OCFs [6–8]. Potency and effectiveness of these procedures have repetitively been proven in numerous articles [1, 9–12]. Due to higher viscosity of the cement during KP procedure, it theoretically seems that its cement leakage incidence would be less than VP [13, 14]. Moreover, restoring vertebral body height and alignment may make KP more attractive among the spinal surgeons, while this method is more time consuming and expensive [7, 8, 10, 13, 15]. Can a single level vertebral height restoration really be associated with better patient’s quality of life? The aim of this prospective study was to evaluate the relative differences that are present in surgical outcome (quality of life and pain intensity) of KP versus VP in the patients with single level refractory OCFs. 2. Materials and Methods From
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