Restoration of vertebral body height and correction of kyphotic deformity after kyphoplasty versus vertebroplasty : special interest in the shape of the fractured vertebrae

Abstract

Study Design: Retrospective comparative analysisObjective: To compare the effectiveness of vertebroplasty (VP) and kyphoplasty (KP) for the treatment of osteoporotic vertebral compression fracture (VCF), we analyzed kyphosis correction, vertebral height restoration, and bone cement leakage in VP group and KP group.Summary of Background Data: Superior results of KP have been reported in regard to kyphotic deformity correction and collapsed vertebral height restoration. However, to our knowledge, there was no research about different results of it according to fractured shape of vertebrae. Methods: A total of 103 patients underwent VP (n=58) and KP (n=45) for osteoporotic VCF between January 2006 and September 2009. We classified patients into six groups: VP (V-shaped), VP (flat-shaped), VP (wedge-shaped), KP (V-shaped), KP (flat-shaped), and KP (wedge-shaped) according to treatment method and fracture type. Then, we compared kyphosis correction, vertebral height restoration and cement leakage of VP group with those in KP groups.Results: KP was better than VP, especially for middle column height restoration and bone cement leakage prevention for all kinds of fracture types (P-value < 0.05). Additionally, KP was superior in anterior height restoration and kyphosis correction on both flat shaped and wedge shaped fracture (P-value < 0.05). However, posterior column vertebral height was not restored even in KP group and VP group. There was no difference between two groups for clinical outcome. (P-value > 0.05)Conclusions: KP has significant advantage compared to VP in kyphosis correction, vertebral height restoration, and cement leakage prevention. We figured out that KP has an obvious advantage in middle vertebral height restoration and cement leakage prevention, especially for V-shaped compression fracture. However, prospective randomized clinical trial study should be needed to confirm our results.