Skip to main content
Top
Published in: Osteoporosis International 6/2016

01-06-2016 | Original Article

Safety and clinical performance of kyphoplasty and SpineJack® procedures in the treatment of osteoporotic vertebral compression fractures: a pilot, monocentric, investigator-initiated study

Authors: D. C. Noriega, R. H. Ramajo, I. S. Lite, B. Toribio, R. Corredera, F. Ardura, A. Krüger

Published in: Osteoporosis International | Issue 6/2016

Login to get access

Abstract

Summary

Clinical performance and safety of two percutaneous vertebral cement augmentation (VA) procedures (SpineJack® and Kyphx Xpander® balloon) were compared in patients with osteoporotic compression fractures. Both techniques were safe, efficient, and led to a rapid and marked improvement in clinical signs; nevertheless, SpineJack showed better restoration of vertebral heights and angles, maintained over time.

Introduction

In patients with osteoporotic vertebral compression fractures (VCFs), both SpineJack® (SJ) and balloon kyphoplasty (BKP) led to a rapid and marked improvement in clinical signs. This pilot, monocentric, investigator-initiated, prospective study aimed to compare two percutaneous vertebral augmentation procedures in the painful osteoporotic VCF treatment.

Methods

Thirty patients were randomized to receive SJ (n = 15) or BKP (n = 15). Analgesic consumption, back pain intensity (visual analog scale (VAS)), and Oswestry Disability Index (ODI) scores were recorded preoperatively, at 5 days and 1, 3, 6, and 12 months post-surgery. Quality of life (EQ-VAS score) was evaluated at 1, 3, 6, and 12 months. Spine X-rays were taken 48 h prior to procedure and 5 days and 6 and 12 months after.

Results

SpineJack® led to a significantly shorter intervention period (23 vs 32 min; p < 0.001), a strong, rapid, and long-lasting decline in pain (94 vs 82 % at 12 months) and in functional disability (94 vs 90 % at 12 months), a greater and sustainable mean correction of anterior (12 ± 13 vs 0 ± 7 % for BKP, p = 0.003) and central height (12 ± 10 vs 2 ± 6 % for BKP, p = 0.001) at 12 months, and a larger restoration of the vertebral body angle still evident 12 months after implantation (−4.4° ± 5.8° vs 0.2° ± 3.0° for BKP; p = 0.012).

Conclusions

This pilot study showed that both techniques were safe and efficient for the osteoporotic VCF treatment. Radiological results indicate that the SpineJack® procedure has a higher potential for vertebral body height restoration and maintenance over time.
Appendix
Available only for authorised users
Literature
1.
go back to reference Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733CrossRefPubMed Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733CrossRefPubMed
2.
go back to reference Wardlaw D, Van Meirhaeghe J, Ranstam J, Bastian L, Boonen S (2012) Balloon kyphoplasty in patients with osteoporotic vertebral compression fractures. Expert Rev Med Devic 9:423–436CrossRef Wardlaw D, Van Meirhaeghe J, Ranstam J, Bastian L, Boonen S (2012) Balloon kyphoplasty in patients with osteoporotic vertebral compression fractures. Expert Rev Med Devic 9:423–436CrossRef
3.
go back to reference Lindsay R, Burge RT, Strauss DM (2005) One year outcomes and costs following a vertebral fracture. Osteoporos Int 16:78–85CrossRefPubMed Lindsay R, Burge RT, Strauss DM (2005) One year outcomes and costs following a vertebral fracture. Osteoporos Int 16:78–85CrossRefPubMed
4.
go back to reference Lau E, Ong K, Kurtz S, Schmier J, Edidin A (2008) Mortality following the diagnosis of a vertebral compression fracture in the Medicare population. J Bone Joint Surg Am 90:1479–1486CrossRefPubMed Lau E, Ong K, Kurtz S, Schmier J, Edidin A (2008) Mortality following the diagnosis of a vertebral compression fracture in the Medicare population. J Bone Joint Surg Am 90:1479–1486CrossRefPubMed
5.
go back to reference Klazen CA, Verhaar HJ, Lohle PN, Lampmann LE, Juttmann JR, Schoemaker MC, van Everdingen KJ, Muller AF, Mali WP, de Vries J (2010) Clinical course of pain in acute osteoporotic vertebral compression fractures. J Vasc Interv Radiol 21:1405–1409CrossRefPubMed Klazen CA, Verhaar HJ, Lohle PN, Lampmann LE, Juttmann JR, Schoemaker MC, van Everdingen KJ, Muller AF, Mali WP, de Vries J (2010) Clinical course of pain in acute osteoporotic vertebral compression fractures. J Vasc Interv Radiol 21:1405–1409CrossRefPubMed
6.
go back to reference Baxter D, Yeh J (2012). The use of polymethyl methacrylate (PMMA) in neurosurgery. In: Luigi Ambrosio, Elizabeth Tanner (ed) Biomaterials for Spinal Surgery, Woodhead Publishing in Materials, Woodhead Publishing Limited, p 380 Baxter D, Yeh J (2012). The use of polymethyl methacrylate (PMMA) in neurosurgery. In: Luigi Ambrosio, Elizabeth Tanner (ed) Biomaterials for Spinal Surgery, Woodhead Publishing in Materials, Woodhead Publishing Limited, p 380
7.
go back to reference Papanastassiou ID, Filis A, Gerochristou MA, Vrionis FD (2014) Controversial issues in kyphoplasty and vertebroplasty in osteoporotic vertebral fractures. Biomed Res Int. doi:10.1155/2014/934206 Papanastassiou ID, Filis A, Gerochristou MA, Vrionis FD (2014) Controversial issues in kyphoplasty and vertebroplasty in osteoporotic vertebral fractures. Biomed Res Int. doi:10.​1155/​2014/​934206
8.
go back to reference Edidin AA, Ong KL, Lau E, Kurtz SM (2012) Cost-effectiveness analysis of treatments for vertebral compression fractures. Appl Health Econ Health Policy 10:273–284CrossRefPubMed Edidin AA, Ong KL, Lau E, Kurtz SM (2012) Cost-effectiveness analysis of treatments for vertebral compression fractures. Appl Health Econ Health Policy 10:273–284CrossRefPubMed
9.
go back to reference Chen AT, Cohen DB, Skolasky RL (2013) Impact of nonoperative treatment, vertebroplasty, and kyphoplasty on survival and morbidity after vertebral compression fracture in the medicare population. J Bone Joint Surg Am 95:1729–1736CrossRefPubMed Chen AT, Cohen DB, Skolasky RL (2013) Impact of nonoperative treatment, vertebroplasty, and kyphoplasty on survival and morbidity after vertebral compression fracture in the medicare population. J Bone Joint Surg Am 95:1729–1736CrossRefPubMed
10.
go back to reference Verlaan JJ, van De Kraats EB, Oner FC, Van Walsum T, Niessen WJ, Dhert WJA (2005) The reduction of endplate fractures during balloon kyphoplasty. Spine 30:1840–1845CrossRefPubMed Verlaan JJ, van De Kraats EB, Oner FC, Van Walsum T, Niessen WJ, Dhert WJA (2005) The reduction of endplate fractures during balloon kyphoplasty. Spine 30:1840–1845CrossRefPubMed
11.
go back to reference Voggenreiter G (2005) Balloon kyphoplasty is effective in deformity correction of osteoporotic vertebral compression fractures. Spine 30:2806–2812CrossRefPubMed Voggenreiter G (2005) Balloon kyphoplasty is effective in deformity correction of osteoporotic vertebral compression fractures. Spine 30:2806–2812CrossRefPubMed
12.
go back to reference Lamy O, Uebelhart B, Aubry-Rozier B (2014) Risks and benefits of percutaneous vertebroplasty or kyphoplasty in the management of osteoporotic vertebral fractures. Osteoporos Int 25(3):807–19CrossRefPubMed Lamy O, Uebelhart B, Aubry-Rozier B (2014) Risks and benefits of percutaneous vertebroplasty or kyphoplasty in the management of osteoporotic vertebral fractures. Osteoporos Int 25(3):807–19CrossRefPubMed
13.
go back to reference Krüger A, Baroud G, Noriega D, Figiel J, Dorschel C, Ruchholtz S, Oberkircher L (2013) Height restoration and maintenance after treating unstable osteoporotic vertebral compression fractures by cement augmentation is dependent on the cement volume used. Clin Biomech 28:725–730CrossRef Krüger A, Baroud G, Noriega D, Figiel J, Dorschel C, Ruchholtz S, Oberkircher L (2013) Height restoration and maintenance after treating unstable osteoporotic vertebral compression fractures by cement augmentation is dependent on the cement volume used. Clin Biomech 28:725–730CrossRef
14.
go back to reference Krüger A, Oberkircher L, Figiel J, Floßdorf F, Bolzinger F, Noriega DC, Ruchholtz S (2015) Height restoration of osteoporotic vertebral compression fractures using different intravertebral reduction devices: a cadaveric study. Spine J 15:1092–1098CrossRefPubMed Krüger A, Oberkircher L, Figiel J, Floßdorf F, Bolzinger F, Noriega DC, Ruchholtz S (2015) Height restoration of osteoporotic vertebral compression fractures using different intravertebral reduction devices: a cadaveric study. Spine J 15:1092–1098CrossRefPubMed
15.
go back to reference Vogler D, Paillex R, Norberg M, de Goumoëns P, Cabri J (2008) Cross-cultural validation of the Oswestry disability index in French. Ann Readapt Med Phys 51:379–385CrossRefPubMed Vogler D, Paillex R, Norberg M, de Goumoëns P, Cabri J (2008) Cross-cultural validation of the Oswestry disability index in French. Ann Readapt Med Phys 51:379–385CrossRefPubMed
16.
go back to reference Brooks R, Rabin R, Charro F (2003) The measurement and valuation of health status using EQ-5D: a European perspective. Evidence from the EuroQol BIOMED. Research programme. Kluwer academic publishers, DordrechtCrossRef Brooks R, Rabin R, Charro F (2003) The measurement and valuation of health status using EQ-5D: a European perspective. Evidence from the EuroQol BIOMED. Research programme. Kluwer academic publishers, DordrechtCrossRef
17.
go back to reference Schulze M, Trautwein F, Vordemvenne T, Raschke M, Heuer F (2011) A method to perform spinal motion analysis from functional X-ray images. J Biomech 44:1740–1746CrossRefPubMed Schulze M, Trautwein F, Vordemvenne T, Raschke M, Heuer F (2011) A method to perform spinal motion analysis from functional X-ray images. J Biomech 44:1740–1746CrossRefPubMed
18.
go back to reference Yeom JS, Kim WJ, Choy WS, Lee CK, Chang BS, Kang JW (2003) Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures. J Bone Joint Surg Brit :83–9 Yeom JS, Kim WJ, Choy WS, Lee CK, Chang BS, Kang JW (2003) Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures. J Bone Joint Surg Brit :83–9
19.
go back to reference Collins SL, Moore RA, McQuay HJ (1997) The visual analogue pain intensity scale: what is moderate pain in millimetres? Pain 72:95–97CrossRefPubMed Collins SL, Moore RA, McQuay HJ (1997) The visual analogue pain intensity scale: what is moderate pain in millimetres? Pain 72:95–97CrossRefPubMed
20.
go back to reference Lee JS, Hobden E, Stiell IG, Wells GA (2003) Clinically important change in the visual analog scale after adequate pain control. Acad Emerg Med 10:1128–1130CrossRefPubMed Lee JS, Hobden E, Stiell IG, Wells GA (2003) Clinically important change in the visual analog scale after adequate pain control. Acad Emerg Med 10:1128–1130CrossRefPubMed
21.
go back to reference Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, Bouter LM, de Vet HC (2008) Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine (Phila Pa 1976) 33:90–94CrossRef Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, Bouter LM, de Vet HC (2008) Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine (Phila Pa 1976) 33:90–94CrossRef
22.
go back to reference Tutton SM, Pflugmacher R, Davidian M, Beall DP, Facchini FR, Garfin SR (2015) KAST Study: the Kiva® System as a vertebral augmentation treatment—a safety and effectiveness trial: a randomized, non-inferiority trial comparing the Kiva® system to balloon kyphoplasty in treatment of osteoporotic vertebral compression fractures. Spine (Phila Pa 1976) 40:865–875CrossRef Tutton SM, Pflugmacher R, Davidian M, Beall DP, Facchini FR, Garfin SR (2015) KAST Study: the Kiva® System as a vertebral augmentation treatment—a safety and effectiveness trial: a randomized, non-inferiority trial comparing the Kiva® system to balloon kyphoplasty in treatment of osteoporotic vertebral compression fractures. Spine (Phila Pa 1976) 40:865–875CrossRef
Metadata
Title
Safety and clinical performance of kyphoplasty and SpineJack® procedures in the treatment of osteoporotic vertebral compression fractures: a pilot, monocentric, investigator-initiated study
Authors
D. C. Noriega
R. H. Ramajo
I. S. Lite
B. Toribio
R. Corredera
F. Ardura
A. Krüger
Publication date
01-06-2016
Publisher
Springer London
Published in
Osteoporosis International / Issue 6/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-016-3494-x

Other articles of this Issue 6/2016

Osteoporosis International 6/2016 Go to the issue