Skip to main content
Top
Published in: European Spine Journal 3/2004

01-05-2004 | Review

Kyphoplasty for treatment of osteoporotic vertebral fractures

Authors: Paul F. Heini, Rene Orler

Published in: European Spine Journal | Issue 3/2004

Login to get access

Abstract

Cement reinforcement for the treatment of osteoporotic vertebral fractures is efficient mean with high success in pain release and prevention of further sintering of the reinforced vertebrae; however, the technique does not allow to address the kyphotic deformity. Kyphoplasty was designed to address the kyphotic deformity and help to realign the spine. It involves the percutaneous placement of an inflatable bone tamp into a vertebral body. Restoration of VB height and kyphosis correction is achieved by inflation of the bone tamp with liquid. After deflation, a cavity is created that eases the cement application. The potential of kyphosis reduction is given in fresh fractures with a range of 0–90% for height restoration and absolute correction of the kyphotic angle of 8.5°. The cavity formation, on one hand, and the different cementing technique leads to lower risk for cement extravasation. An alternative method for kyphosis correction represents the so-called lordoplasty where the adjacent vertebrae are reinforced first and with the cannulas in place acting as a lever the reduction of the collapsed vertebra can be performed. The results with respect to kyphosis correction are superior in comparison with a kyphoplasty procedure.
Literature
1.
go back to reference Barr JD, Barr MS, Lemley TJ, McCann RM (2000) Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 25:923–298PubMed Barr JD, Barr MS, Lemley TJ, McCann RM (2000) Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 25:923–298PubMed
2.
go back to reference Belkoff SM, Jasper LE, Stevens SS (2002) An ex vivo evaluation of an inflatable bone tamp used to reduce fractures within vertebral bodies under load. Spine 27:1640–1643CrossRefPubMed Belkoff SM, Jasper LE, Stevens SS (2002) An ex vivo evaluation of an inflatable bone tamp used to reduce fractures within vertebral bodies under load. Spine 27:1640–1643CrossRefPubMed
3.
go back to reference Belkoff SM, Mathis JM, Deramond H, Jasper LE (2001) An ex vivo biomechanical evaluation of a hydroxyapatite cement for use with kyphoplasty. Am J Neuroradiol 22:1212–1216PubMed Belkoff SM, Mathis JM, Deramond H, Jasper LE (2001) An ex vivo biomechanical evaluation of a hydroxyapatite cement for use with kyphoplasty. Am J Neuroradiol 22:1212–1216PubMed
4.
go back to reference Belkoff SM, Mathis JM, Fenton DC, Scribner RM, Reiley ME, Talmadge K (2001) An ex vivo biomechanical evaluation of an inflatable bone tamp used in the treatment of compression fracture. Spine 26:151–156CrossRefPubMed Belkoff SM, Mathis JM, Fenton DC, Scribner RM, Reiley ME, Talmadge K (2001) An ex vivo biomechanical evaluation of an inflatable bone tamp used in the treatment of compression fracture. Spine 26:151–156CrossRefPubMed
5.
go back to reference Berlemann U, Ferguson SJ, Nolte LP, Heini PF (2002) Adjacent vertebral failure after vertebroplasty: a biomechanical investigation. J Bone Joint Surg Br 84:748–752PubMed Berlemann U, Ferguson SJ, Nolte LP, Heini PF (2002) Adjacent vertebral failure after vertebroplasty: a biomechanical investigation. J Bone Joint Surg Br 84:748–752PubMed
6.
go back to reference Berlemann U, Heini PF (2002) Percutaneous cementing techniques in treatment of osteoporotic spinal sintering. Unfallchirurg 105:2–8 [in German]CrossRef Berlemann U, Heini PF (2002) Percutaneous cementing techniques in treatment of osteoporotic spinal sintering. Unfallchirurg 105:2–8 [in German]CrossRef
7.
go back to reference Bohner M, Gasser B, Baroud G, Heini P (2003) Theoretical and experimental model to describe the injection of a polymethylmethacrylate cement into a porous structure. Biomaterials 24:2721–2730 Bohner M, Gasser B, Baroud G, Heini P (2003) Theoretical and experimental model to describe the injection of a polymethylmethacrylate cement into a porous structure. Biomaterials 24:2721–2730
8.
go back to reference Boszczyk B, Bierschneider M, Potulski M, Robert B, Vastmans J, Jaksche H (2002) Extended kyphoplasty indications for stabilization of osteoporotic vertebral compression fractures. Unfallchirurg 105:952–957 [in German]CrossRef Boszczyk B, Bierschneider M, Potulski M, Robert B, Vastmans J, Jaksche H (2002) Extended kyphoplasty indications for stabilization of osteoporotic vertebral compression fractures. Unfallchirurg 105:952–957 [in German]CrossRef
9.
go back to reference Cook DJ, Guyatt GH, Adachi JD, Clifton J, Griffith LE, Epstein RS, Juniper EF (1993) Quality of life issues in women with vertebral fractures due to osteoporosis. Arthritis Rheum 36:750–756PubMed Cook DJ, Guyatt GH, Adachi JD, Clifton J, Griffith LE, Epstein RS, Juniper EF (1993) Quality of life issues in women with vertebral fractures due to osteoporosis. Arthritis Rheum 36:750–756PubMed
10.
go back to reference Cortet B, Cotten A, Boutry N, Flipo RM, Duquesnoy B, Chastanet P, Delcambre B (1999) Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study. J Rheumatol 26:2222–2228PubMed Cortet B, Cotten A, Boutry N, Flipo RM, Duquesnoy B, Chastanet P, Delcambre B (1999) Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study. J Rheumatol 26:2222–2228PubMed
11.
go back to reference Coumans JV, Reinhardt MK, Lieberman IH (2003) Kyphoplasty for vertebral compression fractures: 1-year clinical outcomes from a prospective study. J Neurosurg 99 (Suppl 1):44–50 Coumans JV, Reinhardt MK, Lieberman IH (2003) Kyphoplasty for vertebral compression fractures: 1-year clinical outcomes from a prospective study. J Neurosurg 99 (Suppl 1):44–50
12.
go back to reference Dudeney S, Lieberman IH, Reinhardt MK, Hussein M (2002) Kyphoplasty in the treatment of osteolytic vertebral compression fractures as a result of multiple myeloma. J Clin Oncol 20:2382–2387CrossRefPubMed Dudeney S, Lieberman IH, Reinhardt MK, Hussein M (2002) Kyphoplasty in the treatment of osteolytic vertebral compression fractures as a result of multiple myeloma. J Clin Oncol 20:2382–2387CrossRefPubMed
13.
go back to reference Einhorn TA (2000) Vertebroplasty: an opportunity to do something really good for patients. Spine 25:1051–1052PubMed Einhorn TA (2000) Vertebroplasty: an opportunity to do something really good for patients. Spine 25:1051–1052PubMed
14.
go back to reference Fourney DR, Schomer DF, Nader R, Chlan-Fourney J, Suki D, Ahrar K, Rhines LD, Gokaslan ZL (2003) Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. J Neurosurg 98 (Suppl 1):21–30 Fourney DR, Schomer DF, Nader R, Chlan-Fourney J, Suki D, Ahrar K, Rhines LD, Gokaslan ZL (2003) Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. J Neurosurg 98 (Suppl 1):21–30
15.
go back to reference Furderer S, Anders M, Schwindling B, Salick M, Duber C, Wenda K, Urban R, Gluck M, Eysel P (2002) Vertebral body stenting: a method for repositioning and augmenting vertebral compression fractures. Orthopade 31:356–361 [in German]PubMed Furderer S, Anders M, Schwindling B, Salick M, Duber C, Wenda K, Urban R, Gluck M, Eysel P (2002) Vertebral body stenting: a method for repositioning and augmenting vertebral compression fractures. Orthopade 31:356–361 [in German]PubMed
16.
go back to reference Garfin SR, Yuan HA, Reiley MA (2001) New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine 26:1511–1515PubMed Garfin SR, Yuan HA, Reiley MA (2001) New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine 26:1511–1515PubMed
17.
go back to reference Gold DT (1996) The clinical impact of vertebral fractures: quality of life in women with osteoporosis. Bone 18 (Suppl 3):185S–189SCrossRefPubMed Gold DT (1996) The clinical impact of vertebral fractures: quality of life in women with osteoporosis. Bone 18 (Suppl 3):185S–189SCrossRefPubMed
18.
go back to reference Heini P, Orler R (in press) Verteborplasty in extreme osteoporosis: experience with multilevel injection. Orthopaede Heini P, Orler R (in press) Verteborplasty in extreme osteoporosis: experience with multilevel injection. Orthopaede
19.
go back to reference Heini PF, Walchli B, Berlemann U (2000) Percutaneous transpedicular vertebroplasty with PMMA: operative technique and early results. A prospective study for the treatment of osteoporotic compression fractures. Eur Spine J 9:445–450PubMed Heini PF, Walchli B, Berlemann U (2000) Percutaneous transpedicular vertebroplasty with PMMA: operative technique and early results. A prospective study for the treatment of osteoporotic compression fractures. Eur Spine J 9:445–450PubMed
20.
go back to reference Hodler J, Peck D, Gilula LA (2003) Midterm outcome after vertebroplasty: predictive value of technical and patient-related factors. Radiology 227:662–668PubMed Hodler J, Peck D, Gilula LA (2003) Midterm outcome after vertebroplasty: predictive value of technical and patient-related factors. Radiology 227:662–668PubMed
21.
go back to reference Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR (1999) Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Arch Intern Med 159:1215–1220PubMed Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR (1999) Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Arch Intern Med 159:1215–1220PubMed
22.
go back to reference Ledlie JT, Renfro M (2003) Balloon kyphoplasty: one-year outcomes in vertebral body height restoration, chronic pain, and activity levels. J Neurosurg 98 (Suppl 1):36–42PubMed Ledlie JT, Renfro M (2003) Balloon kyphoplasty: one-year outcomes in vertebral body height restoration, chronic pain, and activity levels. J Neurosurg 98 (Suppl 1):36–42PubMed
23.
go back to reference Leech JA, Dulberg C, Kellie S, Pattee L, Gay J (1990) Relationship of lung function to severity of osteoporosis in women. Am Rev Respir Dis 141:68–71PubMed Leech JA, Dulberg C, Kellie S, Pattee L, Gay J (1990) Relationship of lung function to severity of osteoporosis in women. Am Rev Respir Dis 141:68–71PubMed
24.
go back to reference Lieberman IH, Dudeney S, Reinhardt MK, Bell G (2001) Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine 26:1631–1638PubMed Lieberman IH, Dudeney S, Reinhardt MK, Bell G (2001) Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine 26:1631–1638PubMed
25.
go back to reference McKiernan F, Jensen R, Faciszewski T (2003) The dynamic mobility of vertebral compression fractures. J Bone Miner Res 18:24–29 McKiernan F, Jensen R, Faciszewski T (2003) The dynamic mobility of vertebral compression fractures. J Bone Miner Res 18:24–29
26.
go back to reference Mousavi P, Roth S, Finkelstein J, Cheung G, Whyne C (2003) Volumetric quantification of cement leakage following percutaneous vertebroplasty in metastatic and osteoporotic vertebrae. J Neurosurg 99 (Suppl 1):56–59PubMed Mousavi P, Roth S, Finkelstein J, Cheung G, Whyne C (2003) Volumetric quantification of cement leakage following percutaneous vertebroplasty in metastatic and osteoporotic vertebrae. J Neurosurg 99 (Suppl 1):56–59PubMed
27.
28.
go back to reference Perez-Higueras A, Alvarez L, Rossi RE, Quinones D, Al-Assir I (2002) Percutaneous vertebroplasty: long-term clinical and radiological outcome. Neuroradiology 44:950–954PubMed Perez-Higueras A, Alvarez L, Rossi RE, Quinones D, Al-Assir I (2002) Percutaneous vertebroplasty: long-term clinical and radiological outcome. Neuroradiology 44:950–954PubMed
29.
go back to reference Phillips FM, Todd-Wetzel F, Lieberman I, Campbell-Hupp M (2002) An in vivo comparison of the potential for extravertebral cement leak after vertebroplasty and kyphoplasty. Spine 27:2173–2179PubMed Phillips FM, Todd-Wetzel F, Lieberman I, Campbell-Hupp M (2002) An in vivo comparison of the potential for extravertebral cement leak after vertebroplasty and kyphoplasty. Spine 27:2173–2179PubMed
30.
go back to reference Riggs BL, Melton LJ III (1995) The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 17 (Suppl 5):505S–511SPubMed Riggs BL, Melton LJ III (1995) The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 17 (Suppl 5):505S–511SPubMed
31.
go back to reference Ryan PJ, Blake G, Herd R, Fogelman I (1994) A clinical profile of back pain and disability in patients with spinal osteoporosis. Bone 15:27–30PubMed Ryan PJ, Blake G, Herd R, Fogelman I (1994) A clinical profile of back pain and disability in patients with spinal osteoporosis. Bone 15:27–30PubMed
32.
go back to reference Schlaich C, Minne HW, Bruckner T, Wagner G, Gebest HJ, Grunze M, Ziegler R, Leidig-Bruckner G (1998) Reduced pulmonary function in patients with spinal osteoporotic fractures. Osteoporos Int 8:261–267PubMed Schlaich C, Minne HW, Bruckner T, Wagner G, Gebest HJ, Grunze M, Ziegler R, Leidig-Bruckner G (1998) Reduced pulmonary function in patients with spinal osteoporotic fractures. Osteoporos Int 8:261–267PubMed
33.
go back to reference Silverman SL (1992) The clinical consequences of vertebral compression fracture. Bone 13 (Suppl 2):S27–S31PubMed Silverman SL (1992) The clinical consequences of vertebral compression fracture. Bone 13 (Suppl 2):S27–S31PubMed
34.
go back to reference Theodorou DJ, Theodorou SJ, Duncan TD, Garfin SR, Wong WH (2002) Percutaneous balloon kyphoplasty for the correction of spinal deformity in painful vertebral body compression fractures. Clin Imaging 26:1–5CrossRefPubMed Theodorou DJ, Theodorou SJ, Duncan TD, Garfin SR, Wong WH (2002) Percutaneous balloon kyphoplasty for the correction of spinal deformity in painful vertebral body compression fractures. Clin Imaging 26:1–5CrossRefPubMed
35.
go back to reference Tomita S, Kin A, Yazu M, Abe M (2003) Biomechanical evaluation of kyphoplasty and vertebroplasty with calcium phosphate cement in a simulated osteoporotic compression fracture. J Orthop Sci 8:192–197CrossRefPubMed Tomita S, Kin A, Yazu M, Abe M (2003) Biomechanical evaluation of kyphoplasty and vertebroplasty with calcium phosphate cement in a simulated osteoporotic compression fracture. J Orthop Sci 8:192–197CrossRefPubMed
36.
go back to reference Verlaan JJ, van Helden WH, Oner FC, Verbout AJ, Dhert WJ (2002) Balloon vertebroplasty with calcium phosphate cement augmentation for direct restoration of traumatic thoracolumbar vertebral fractures. Spine 27:543–548CrossRefPubMed Verlaan JJ, van Helden WH, Oner FC, Verbout AJ, Dhert WJ (2002) Balloon vertebroplasty with calcium phosphate cement augmentation for direct restoration of traumatic thoracolumbar vertebral fractures. Spine 27:543–548CrossRefPubMed
37.
go back to reference Weisskopf M, Herlein S, Birnbaum K, Siebert C, Stanzel S, Wirtz DC (2003) Kyphoplasty—a new minimally invasive treatment for repositioning and stabilising vertebral bodies. Z Orthop Ihre Grenzgeb 141:406–411 [in German]CrossRefPubMed Weisskopf M, Herlein S, Birnbaum K, Siebert C, Stanzel S, Wirtz DC (2003) Kyphoplasty—a new minimally invasive treatment for repositioning and stabilising vertebral bodies. Z Orthop Ihre Grenzgeb 141:406–411 [in German]CrossRefPubMed
38.
go back to reference Wilson DR, Myers ER, Mathis JM, Scribner RM, Conta JA, Reiley MA, Talmadge KD, Hayes WC (2000) Effect of augmentation on the mechanics of vertebral wedge fractures. Spine 25:158–165CrossRefPubMed Wilson DR, Myers ER, Mathis JM, Scribner RM, Conta JA, Reiley MA, Talmadge KD, Hayes WC (2000) Effect of augmentation on the mechanics of vertebral wedge fractures. Spine 25:158–165CrossRefPubMed
39.
go back to reference Wong W, Mathis J (2002) Is intraosseous venography a significant safety measure in performance of vertebroplasty? J Vasc Interv Radiol 13:137–138PubMed Wong W, Mathis J (2002) Is intraosseous venography a significant safety measure in performance of vertebroplasty? J Vasc Interv Radiol 13:137–138PubMed
40.
go back to reference Wong W, Riley MA, Garfin S (2000) Vertebroplasty/kyphoplasty. J Womens Imaging 2:117–124 Wong W, Riley MA, Garfin S (2000) Vertebroplasty/kyphoplasty. J Womens Imaging 2:117–124
41.
go back to reference Zoarski GH, Snow P, Olan WJ, Stallmeyer MJ, Dick BW, Hebel JR, de Deyne M (2002) Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. J Vasc Interv Radiol 13:139–148PubMed Zoarski GH, Snow P, Olan WJ, Stallmeyer MJ, Dick BW, Hebel JR, de Deyne M (2002) Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. J Vasc Interv Radiol 13:139–148PubMed
Metadata
Title
Kyphoplasty for treatment of osteoporotic vertebral fractures
Authors
Paul F. Heini
Rene Orler
Publication date
01-05-2004
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 3/2004
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-003-0654-4

Other articles of this Issue 3/2004

European Spine Journal 3/2004 Go to the issue