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Comparing Vertebroplasty and Kyphoplasty for Vertebral Compression Fractures

Posted on: 05/15/2008
Vertebral compression fractures (VCFs) can be treated with vertebroplasty or kyphoplasty. Comparing the results of these two procedures will help surgeons decide which procedure to use for each patient. In this study, 168 published articles on these treatment techniques were analyzed. The authors present a summary of the findings.

Vertebroplasty and kyphoplasty are fairly similar procedures. In vertebroplasty, cement is injected into the collapsed vertebral body. The cement fills all the cracks and openings in the fracture. Once the cement hardens, it provides a stable segment that won't collapse further.

In kyphoplasty, a balloon is inserted first into a collapsed vertebra. The balloon is inflated to create a cavity and then deflated and removed. Then bone cement is injected into the space created by the balloon. The fracture is stabilized and the height of the vertebral column in maintained. Both procedures are used to control pain and prevent spine deformity associated with VCFs.

The importance of this study is that it is a meta-analysis of the current literature. That means data from many smaller but acceptable studies was pooled together and analyzed. The results give us a reliable way to see how effective these two treatments are and how the outcomes compare. Type and rate of complications were also included.

Of the 1,036 studies available, 168 met all the pre-set standards to be included in the meta-analysis. The majority of the articles reported on vertebroplasty. Kyphoplasty was used and/or studied less often.

Pain relief and complications were the two areas compared. Patients in both groups got good pain reduction. Vertebroplasty was more effective in decreasing patients' pain levels. But the difference between the two treatment methods wasn't statistically significant. That suggests patients benefit equally, no matter which method is used.

Problems with cement leakage and new compression fractures were more likely to occur with vertebroplasty. But there was a greater risk of heart attack with the kyphoplasty procedure.

The authors conclude that vertebroplasty and kyphoplasty achieve similar results. There's a greater risk of complications with vertebroplasty. In general, more studies are needed comparing these two procedures with each other and with other medical (nonoperative) care. Longer follow-up periods are needed to see just what are the long-term effects of each treatment.

References:
Jason C. Eck, DO, MS, et al. Comparison of Vertebroplasty and Balloon Kyphoplasty for Treatment of Vertebral Compression Fractures: A Meta-Analysis of the Literature. In The Spine Journal. May 2008. Vol. 8. No. 3. Pp. 488-497.

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