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Current Reviews in Musculoskeletal Medicine

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Open Access 01-03-2008

Vertebroplasty and kyphoplasty: a comparative review of efficacy and adverse events

Authors: Todd McCall, Chad Cole, Andrew Dailey

Published in: Current Reviews in Musculoskeletal Medicine | Issue 1/2008

Abstract

Vertebroplasty and kyphoplasty have become common surgical techniques for the treatment of vertebral compression fractures. Vertebroplasty involves the percutaneous injection of bone cement into the cancellous bone of a vertebral body with the goals of pain alleviation and preventing further loss of vertebral body height. Kyphoplasty utilizes an inflatable balloon to create a cavity for the cement with the additional potential goals of restoring height and reducing kyphosis. Vertebroplasty and kyphoplasty are effective treatment options for the reduction of pain associated with vertebral body compression fractures. Biomechanical studies demonstrate that kyphoplasty is initially superior for increasing vertebral body height and reducing kyphosis, but these gains are lost with repetitive loading. Complications secondary to extravasation of cement include compression of neural elements and venous embolism. These complications are rare but more common with vertebroplasty. Vertebroplasty and kyphoplasty are both safe and effective procedures for the treatment of vertebral body compression fractures.

Dickman CA, Fessler RG, MacMillan M, et al. Transpedicular screw-rod fixation of the lumbar spine: operative technique and outcome in 104 cases. J Neurosurg 1992;77:860–70.PubMed

Galibert P, Deramond H, Rosat P, et al. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 1987;33:166–8.PubMed

McGraw JK, Lippert JA, Minkus KD, et al. Prospective evaluation of pain relief in 100 patients undergoing percutaneous vertebroplasty: results and follow-up. J Vasc Interv Radiol 2002;13:883–6.PubMedCrossRef

Zoarski GH, Snow P, Olan WJ, et al. Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. J Vasc Interv Radiol 2002;13:139–48.PubMedCrossRef

Atalay B, Caner H, Gokce C, et al. Kyphoplasty: 2 years of experience in a neurosurgery department. Surg Neurol 2005;64(Suppl 2):S72–6.PubMedCrossRef

Burton AW, Mendel E. Vertebroplasty and kyphoplasty. Pain Physician 2003;6:335–41.PubMed

Kaemmerlen P, Thiesse P, Jonas P, et al. Percutaneous injection of orthopedic cement in metastatic vertebral lesions. N Engl J Med 1989;321:121.PubMed

Tschirhart CE, Finkelstein JA, Whyne CM. Optimization of tumor volume reduction and cement augmentation in percutaneous vertebroplasty for prophylactic treatment of spinal metastases. J Spinal Disord Tech 2006;19:584–90.PubMedCrossRef

Lieberman IH, Dudeney S, Reinhardt MK, et al. Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine 2001;26:1631–8.PubMedCrossRef

10.

Cooper C, Atkinson EJ, O’Fallon WM, et al. Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res 1992;7:221–7.PubMedCrossRef

11.

Silverman SL. The clinical consequences of vertebral compression fracture. Bone 1992;13(Suppl 2):S27–31.PubMedCrossRef

12.

Melton LJ 3rd, Kan SH, Frye MA, et al. Epidemiology of vertebral fractures in women. Am J Epidemiol 1989;129:1000–11.PubMed

13.

Riggs BL, Melton LJ 3rd. The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 1995;17:505S–11S.PubMedCrossRef

14.

Gaughen JR Jr, Jensen ME, Schweickert PA, et al. Relevance of antecedent venography in percutaneous vertebroplasty for the treatment of osteoporotic compression fractures. Am J Neuroradiol 2002;23:594–600.PubMed

15.

Burton AW, Rhines LD, Mendel E. Vertebroplasty and kyphoplasty: a comprehensive review. Neurosurg Focus 2005;18:e1.PubMedCrossRef

16.

Phillips FM, Ho E, Campbell-Hupp M, et al. Early radiographic and clinical results of balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures. Spine 2003;28:2260–7.PubMedCrossRef

17.

Leech JA, Dulberg C, Kellie S, et al. Relationship of lung function to severity of osteoporosis in women. Am Rev Respir Dis 1990;141:68–71.PubMed

18.

Schlaich C, Minne HW, Bruckner T, et al. Reduced pulmonary function in patients with spinal osteoporotic fractures. Osteoporos Int 1998;8:261–7.PubMedCrossRef

19.

Kado DM, Browner WS, Palermo L, et al. Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Arch Intern Med 1999;159:1215–20.PubMedCrossRef

20.

Rapado A. General management of vertebral fractures. Bone 1996;18:191S–6S.PubMedCrossRef

21.

Reginster J, Minne HW, Sorensen OH, et al. Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. Osteoporos Int 2000;11:83–91.PubMedCrossRef

22.

Palombaro KM. Effects of walking-only interventions on bone mineral density at various skeletal sites: a meta-analysis. J Geriatr Phys Ther 2005;28:102–7.PubMed

23.

Khosla S, Riggs BL. Treatment options for osteoporosis. Mayo Clin Proc 1995;70:978–82.PubMedCrossRef

24.

Baker LL, Goodman SB, Perkash I, et al. Benign versus pathologic compression fractures of vertebral bodies: assessment with conventional spin-echo, chemical-shift, and STIR MR imaging. Radiology 1990;174:495–502.PubMed

25.

Maynard AS, Jensen ME, Schweickert PA, et al. Value of bone scan imaging in predicting pain relief from percutaneous vertebroplasty in osteoporotic vertebral fractures. Am J Neuroradiol 2000;21:1807–12.PubMed

26.

Amar AP, Larsen DW, Esnaashari N, et al. Percutaneous transpedicular polymethylmethacrylate vertebroplasty for the treatment of spinal compression fractures. Neurosurgery 2001;49:1105–15.PubMedCrossRef

27.

Barr JD, Barr MS, Lemley TJ, et al. Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 2000;25:923–8.PubMedCrossRef

28.

Cotten A, Boutry N, Cortet B, et al. Percutaneous vertebroplasty: state of the art. Radiographics 1998;18:311–23.PubMed

29.

Peters KR, Guiot BH, Martin PA, et al. Vertebroplasty for osteoporotic compression fractures: current practice and evolving techniques. Neurosurgery 2002;51:S96–103.PubMedCrossRef

30.

Weill A, Chiras J, Simon JM, et al. Spinal metastases: indications for and results of percutaneous injection of acrylic surgical cement. Radiology 1996;199:241–7.PubMed

31.

Kim AK, Jensen ME, Dion JE, et al. Unilateral transpedicular percutaneous vertebroplasty: initial experience. Radiology 2002;222:737–41.PubMedCrossRef

32.

Molloy S, Riley LH 3rd, Belkoff SM. Effect of cement volume and placement on mechanical-property restoration resulting from vertebroplasty. Am J Neuroradiol 2005;26:401–4.PubMed

33.

Steinmann J, Tingey CT, Cruz G, et al. Biomechanical comparison of unipedicular versus bipedicular kyphoplasty. Spine 2005;30:201–5.PubMedCrossRef

34.

McGraw JK, Heatwole EV, Strnad BT, et al. Predictive value of intraosseous venography before percutaneous vertebroplasty. J Vasc Interv Radiol 2002;13:149–53.PubMedCrossRef

35.

Vasconcelos C, Gailloud P, Beauchamp NJ, et al. Is percutaneous vertebroplasty without pretreatment venography safe? Evaluation of 205 consecutives procedures. Am J Neuroradiol 2002;23:913–7.PubMed

36.

Belkoff SM, Mathis JM, Deramond H, et al. An ex vivo biomechanical evaluation of a hydroxyapatite cement for use with kyphoplasty. Am J Neuroradiol 2001;22:1212–6.PubMed

37.

Belkoff SM, Mathis JM, Jasper LE. Ex vivo biomechanical comparison of hydroxyapatite and polymethylmethacrylate cements for use with vertebroplasty. Am J Neuroradiol 2002;23:1647–51.PubMed

38.

Jasper LE, Deramond H, Mathis JM, et al. Material properties of various cements for use with vertebroplasty. J Mater Sci Mater Med 2002;13:1–5.PubMedCrossRef

39.

Jensen ME, Evans AJ, Mathis JM, et al. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. Am J Neuroradiol 1997;18:1897–904.PubMed

40.

Mathis JM, Petri M, Naff N. Percutaneous vertebroplasty treatment of steroid-induced osteoporotic compression fractures. Arthritis Rheum 1998;41:171–5.PubMedCrossRef

41.

Perry A, Mahar A, Massie J, et al. Biomechanical evaluation of kyphoplasty with calcium sulfate cement in a cadaveric osteoporotic vertebral compression fracture model. Spine J 2005;5:489–93.PubMedCrossRef

42.

Tomita S, Kin A, Yazu M, et al. Biomechanical evaluation of kyphoplasty and vertebroplasty with calcium phosphate cement in a simulated osteoporotic compression fracture. J Orthop Sci 2003;8:192–7.PubMedCrossRef

43.

Tomita S, Molloy S, Jasper LE, et al. Biomechanical comparison of kyphoplasty with different bone cements. Spine 2004;29:1203–7.PubMedCrossRef

44.

Wilke HJ, Mehnert U, Claes LE, et al. Biomechanical evaluation of vertebroplasty and kyphoplasty with polymethyl methacrylate or calcium phosphate cement under cyclic loading. Spine 2006;31:2934–41.PubMedCrossRef

45.

Belkoff SM, Mathis JM, Jasper LE, et al. The biomechanics of vertebroplasty. The effect of cement volume on mechanical behavior. Spine 2001;26:1537–41.PubMedCrossRef

46.

Kim MJ, Lindsey DP, Hannibal M, et al. Vertebroplasty versus kyphoplasty: biomechanical behavior under repetitive loading conditions. Spine 2006;31:2079–84.PubMedCrossRef

47.

Taylor RS, Taylor RJ, Fritzell P. Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety. Spine 2006;31:2747–55.PubMedCrossRef

48.

Fourney DR, Schomer DF, Nader R, et al. Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. J Neurosurg 2003;98:21–30.PubMedCrossRef

49.

Kasperk C, Hillmeier J, Noldge G, et al. Treatment of painful vertebral fractures by kyphoplasty in patients with primary osteoporosis: a prospective nonrandomized controlled study. J Bone Miner Res 2005;20:604–12.PubMedCrossRef

50.

Hulme PA, Krebs J, Ferguson SJ, et al. Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine 2006;31:1983–2001.PubMedCrossRef

51.

Berlemann U, Franz T, Orler R, et al. Kyphoplasty for treatment of osteoporotic vertebral fractures: a prospective non-randomized study. Eur Spine J 2004;13:496–501.PubMedCrossRef

52.

Chiras J, Depriester C, Weill A, et al. Percutaneous vertebral surgery. Technics and indications. J Neuroradiol 1997;24:45–59.PubMed

53.

Mathis JM, Barr JD, Belkoff SM, et al. Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. Am J Neuroradiol 2001;22:373–81.PubMed

54.

Lee BJ, Lee SR, Yoo TY. Paraplegia as a complication of percutaneous vertebroplasty with polymethylmethacrylate: a case report. Spine 2002;27:E419–22.PubMedCrossRef

55.

Ratliff J, Nguyen T, Heiss J. Root and spinal cord compression from methylmethacrylate vertebroplasty. Spine 2001;26:E300–2.PubMedCrossRef

56.

Chen HL, Wong CS, Ho ST, et al. A lethal pulmonary embolism during percutaneous vertebroplasty. Anesth Analg 2002;95:1060–2.PubMedCrossRef

57.

Jang JS, Lee SH, Jung SK. Pulmonary embolism of polymethylmethacrylate after percutaneous vertebroplasty: a report of three cases. Spine 2002;27:E416–8.PubMedCrossRef

58.

Tozzi P, Abdelmoumene Y, Corno AF, et al. Management of pulmonary embolism during acrylic vertebroplasty. Ann Thorac Surg 2002;74:1706–8.PubMedCrossRef

59.

Nussbaum DA, Gailloud P, Murphy K. A review of complications associated with vertebroplasty and kyphoplasty as reported to the Food and Drug Administration medical device related web site. J Vasc Interv Radiol 2004;15:1185–92.PubMed

60.

Walker DH, Mummaneni P, Rodts GE Jr. Infected vertebroplasty. Report of two cases and review of the literature. Neurosurg Focus 2004;17:E6.PubMedCrossRef

61.

Phillips FM, Todd Wetzel F, Lieberman I, et al. An in vivo comparison of the potential for extravertebral cement leak after vertebroplasty and kyphoplasty. Spine 2002;27:2173–9.PubMedCrossRef

62.

Cortet B, Cotten A, Boutry N, et al. Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study. J Rheumatol 1999;26:2222–8.PubMed

63.

Fribourg D, Tang C, Sra P, et al. Incidence of subsequent vertebral fracture after kyphoplasty. Spine 2004;29:2270–7.PubMedCrossRef

64.

Grados F, Depriester C, Cayrolle G, et al. Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheumatology (Oxford) 2000;39:1410–4.CrossRef

65.

Kim SH, Kang HS, Choi JA, et al. Risk factors of new compression fractures in adjacent vertebrae after percutaneous vertebroplasty. Acta Radiol 2004;45:440–5.PubMedCrossRef

66.

Lin EP, Ekholm S, Hiwatashi A, et al. Vertebroplasty: cement leakage into the disc increases the risk of new fracture of adjacent vertebral body. Am J Neuroradiol 2004;25:175–80.PubMed

67.

Uppin AA, Hirsch JA, Centenera LV, et al. Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. Radiology 2003;226:119–24.PubMedCrossRef

68.

Lindsay R, Silverman SL, Cooper C, et al. Risk of new vertebral fracture in the year following a fracture. J Am Med Assoc 2001;285:320–3.CrossRef

69.

Perez-Higueras A, Alvarez L, Rossi RE, et al. Percutaneous vertebroplasty: long-term clinical and radiological outcome. Neuroradiology 2002;44:950–4.PubMedCrossRef

70.

Melton LJ 3rd, Atkinson EJ, Cooper C, et al. Vertebral fractures predict subsequent fractures. Osteoporos Int 1999;10:214–21.PubMedCrossRef

71.

Chung SK, Lee SH, Kim DY, et al. Treatment of lower lumbar radiculopathy caused by osteoporotic compression fracture: the role of vertebroplasty. J Spinal Disord Tech 2002;15:461–8.PubMed

72.

Hentschel SJ, Burton AW, Fourney DR, et al. Percutaneous vertebroplasty and kyphoplasty performed at a cancer center: refuting proposed contraindications. J Neurosurg Spine 2005;2:436–40.PubMed

73.

Nakano M, Hirano N, Matsuura K, et al. Percutaneous transpedicular vertebroplasty with calcium phosphate cement in the treatment of osteoporotic vertebral compression and burst fractures. J Neurosurg 2002;97:287–93.PubMed

74.

Peh WC, Gilula LA, Peck DD. Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Radiology 2002;223:121–6.PubMedCrossRef

75.

Wetzel SG, Martin JB, Somon T, et al. Painful osteolytic metastasis of the atlas: treatment with percutaneous vertebroplasty. Spine 2002;27:E493–5.PubMedCrossRef

76.

Acosta FL Jr, Aryan HE, Taylor WR, et al. Kyphoplasty-augmented short-segment pedicle screw fixation of traumatic lumbar burst fractures: initial clinical experience and literature review. Neurosurg Focus 2005;18:e9.PubMed

77.

Cho DY, Lee WY, Sheu PC. Treatment of thoracolumbar burst fractures with polymethyl methacrylate vertebroplasty and short-segment pedicle screw fixation. Neurosurgery 2003;53:1354–61.PubMedCrossRef

78.

Sarzier JS, Evans AJ, Cahill DW. Increased pedicle screw pullout strength with vertebroplasty augmentation in osteoporotic spines. J Neurosurg 2002;96:309–12.PubMed

79.

Gerszten PC, Germanwala A, Burton SA, et al. Combination kyphoplasty and spinal radiosurgery: a new treatment paradigm for pathological fractures. Neurosurg Focus 2005;18:e8.PubMed

Title: Vertebroplasty and kyphoplasty: a comparative review of efficacy and adverse events
Authors: Todd McCall
Chad Cole
Andrew Dailey
Publication date: 01-03-2008
Publisher: Humana Press Inc
Published in: Current Reviews in Musculoskeletal Medicine / Issue 1/2008
Electronic ISSN: 1935-9748
DOI: https://doi.org/10.1007/s12178-007-9013-0

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Vertebroplasty and kyphoplasty: a comparative review of efficacy and adverse events

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Keynote webinar | Spotlight on medication adherence

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