Comparative study between vertebroplasty and kyphoplasty in management of osteoporotic vertebral body fractures

Abstract

Background: Percutaneous vertebroplasty and percutaneous kyphoplasty are effective minimally invasive procedures in reducing pain and improving the quality of life in patients with osteoporotic vertebral compression fractures with different degrees, but it may lead to serious neurological complications. Results: Twenty-five patients were included in our study. Both techniques were done under local anesthesia using bi-pedicular approach. All cases were assessed using plain radiographs pre- and post-operative, Visual Analogue Scale for pain, and modified Oswestry Disability Index for functional disability. Thirteen patients had vertebroplasty and 12 patients had kyphoplasty. The mean age for vertebroplasty group was 66.94 ± 6.71, while in kyphoplasty group, the mean age was 70.38 ± 9.21. In vertebroplasty group, there were ten females and three males, while in kyphoplasty group, there were nine females and three males. All cases had single vertebral level affection except one patient in the vertebroplasty group that had double-level affection. In vertebroplasty group, ten patients had lumbar spine affection, two patients had dorsal spine affection and one patient had combined dorsal and lumbar spine affection. In kyphoplasty group, ten patients had lumbar spine affection and two patients had dorsal spine affection. The mean post-operative Visual Analogue Scale was 0.46 and 0.50 in vertebroplasty and kyphoplasty groups, respectively. The mean post-operative modified Oswestry Disability Index became 4.15 and 4 in vertebroplasty and kyphoplasty groups, respectively. The mean post-operative local kyphotic angle was 6.0° and 6.50° in vertebroplasty and kyphoplasty groups, respectively. The mean vertebral height became 73.15% and 75% post-operatively in vertebroplasty and kyphoplasty groups, respectively. The intra-operative cement leakage occurred in three cases of vertebroplasty group and one case of kyphoplasty group (P = 0.644). The cost of kyphoplasty was very high in comparison with vertebroplasty. Conclusions: There is no difference between vertebroplasty and kyphoplasty as regard pain relief, improved quality of life, correction of kyphotic angle, vertebral height restoration and the incidence of cement leakage except that kyphoplasty has a very high cost than vertebroplasty. Therefore, both techniques have an equal effect in treating osteoporotic vertebral compression fractures.