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Published in: European Spine Journal 9/2012

01-09-2012 | Original Article

Social implications of balloon kyphoplasty: prospective study from a single UK centre

Authors: Zdenek Klezl, Navjot Bhangoo, Jonathan Phillips, Girish Swamy, Denis Calthorpe, Rajendra Bommireddy

Published in: European Spine Journal | Issue 9/2012

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Abstract

Purpose

The incidence of osteoporotic fractures is increasing with an ageing population. This has potential consequences for health services, patients and their families. Treatment of osteoporotic vertebral compression fractures (OVCFs) has been limited to non-surgical measures so far. The social and functional consequences of balloon kyphoplasty, a recent development for the treatment of VCF, were assessed in this cohort study.

Methods

Data collected prospectively from 53 patients undergoing balloon kyphoplasty for symptomatic OVCF in our hospital’s spinal unit were compared with data from an historical age-matched group of 51 consecutive patients treated conservatively for symptomatic OVCF. Social functionality was recorded prior to the injury, and at 6-month and 1-year follow-up; mortality was recorded at 6 months and 1 year.

Results

The mortality rate in the balloon kyphoplasty group was 11 % (6/53) at 1 year post-OVCF, versus 22 % (11/51) in the conservatively treated controls. A drift to a lower level of social functionality (defined by a lower level of independence) was observed at 1 year in 21 % of patients in the balloon kyphoplasty group versus 53 % of patients in the conservatively treated group. A drift to a lower level of independence was noted in 67 % of the conservatively treated patients who started at a lower level of functionality versus 20 % drift in a similar group who were treated with balloon kyphoplasty.

Conclusions

The reduction in mortality and drift in social functionality at 1 year following treatment with balloon kyphoplasty suggests that it is a viable option for the management of OVCFs.
Literature
1.
3.
go back to reference Scane AC, Sutcliffe AM, Francis RM (1994) The sequelae of vertebral crush fractures in men. Osteoporos Int 4:89–92PubMedCrossRef Scane AC, Sutcliffe AM, Francis RM (1994) The sequelae of vertebral crush fractures in men. Osteoporos Int 4:89–92PubMedCrossRef
4.
go back to reference Jensen ME, McGraw JK, Cardella JF, Hirsch JA (2007) Position statement on percutaneous vertebral augmentation: a consensus statement developed by the American Society of Interventional and Therapeutic Neuroradiology, Society of Interventional Radiology, American Association of Neurological Surgeons/Congress of Neurological Surgeons, and American Society of Spine Radiology. J Vasc Interv Radiol 18:325–330PubMedCrossRef Jensen ME, McGraw JK, Cardella JF, Hirsch JA (2007) Position statement on percutaneous vertebral augmentation: a consensus statement developed by the American Society of Interventional and Therapeutic Neuroradiology, Society of Interventional Radiology, American Association of Neurological Surgeons/Congress of Neurological Surgeons, and American Society of Spine Radiology. J Vasc Interv Radiol 18:325–330PubMedCrossRef
5.
go back to reference Han S, Wan S, Ning L, Tong Y, Zhang J, Fan S (2011) Percutaneous vertebroplasty versus balloon kyphoplasty for treatment of osteoporotic vertebral compression fracture: a meta-analysis of randomised and non-randomised controlled trials. Int Orthop 35:1349–1358PubMedCrossRef Han S, Wan S, Ning L, Tong Y, Zhang J, Fan S (2011) Percutaneous vertebroplasty versus balloon kyphoplasty for treatment of osteoporotic vertebral compression fracture: a meta-analysis of randomised and non-randomised controlled trials. Int Orthop 35:1349–1358PubMedCrossRef
6.
go back to reference McGirt MJ, Parker SL, Wolinsky JP, Witham TF, Bydon A, Gokaslan ZL (2009) Vertebroplasty and kyphoplasty for the treatment of vertebral compression fractures: an evidenced-based review of the literature. Spine J 9:501–508PubMedCrossRef McGirt MJ, Parker SL, Wolinsky JP, Witham TF, Bydon A, Gokaslan ZL (2009) Vertebroplasty and kyphoplasty for the treatment of vertebral compression fractures: an evidenced-based review of the literature. Spine J 9:501–508PubMedCrossRef
7.
go back to reference Gill JB, Kuper M, Chin PC, Zhang Y, Schutt R Jr (2007) Comparing pain reduction following kyphoplasty and vertebroplasty for osteoporotic vertebral compression fractures. Pain Physician 10:583–590PubMed Gill JB, Kuper M, Chin PC, Zhang Y, Schutt R Jr (2007) Comparing pain reduction following kyphoplasty and vertebroplasty for osteoporotic vertebral compression fractures. Pain Physician 10:583–590PubMed
8.
go back to reference Eck JC, Nachtigall D, Humphreys SC, Hodges SD (2008) Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature. Spine J 8:488–497PubMedCrossRef Eck JC, Nachtigall D, Humphreys SC, Hodges SD (2008) Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature. Spine J 8:488–497PubMedCrossRef
9.
go back to reference Hulme PA, Krebs J, Ferguson SJ, Berlemann U (2006) Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine 31:1983–2001PubMedCrossRef Hulme PA, Krebs J, Ferguson SJ, Berlemann U (2006) Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine 31:1983–2001PubMedCrossRef
10.
go back to reference Ploeg WT, Veldhuizen AG, The B, Sietsma MS (2006) Percutaneous vertebroplasty as a treatment for osteoporotic vertebral compression fractures: a systematic review. Eur Spine J 15:1749–1758PubMedCrossRef Ploeg WT, Veldhuizen AG, The B, Sietsma MS (2006) Percutaneous vertebroplasty as a treatment for osteoporotic vertebral compression fractures: a systematic review. Eur Spine J 15:1749–1758PubMedCrossRef
11.
go back to reference Buchbinder R, Osborne RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, Graves S, Staples MP, Murphy B (2009) A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 361:557–568PubMedCrossRef Buchbinder R, Osborne RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, Graves S, Staples MP, Murphy B (2009) A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 361:557–568PubMedCrossRef
12.
go back to reference Kallmes DF, Comstock BA, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH, Edwards R, Gray LA, Stout L, Owen S, Hollingworth W, Ghdoke B, Annesley-Williams DJ, Ralston SH, Jarvik JG (2009) A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 361:569–579PubMedCrossRef Kallmes DF, Comstock BA, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH, Edwards R, Gray LA, Stout L, Owen S, Hollingworth W, Ghdoke B, Annesley-Williams DJ, Ralston SH, Jarvik JG (2009) A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 361:569–579PubMedCrossRef
13.
go back to reference Boszczyk B (2010) Volume matters: a review of procedural details of two randomised controlled vertebroplasty trials of 2009. Eur Spine J 19:1837–1840PubMedCrossRef Boszczyk B (2010) Volume matters: a review of procedural details of two randomised controlled vertebroplasty trials of 2009. Eur Spine J 19:1837–1840PubMedCrossRef
14.
go back to reference Bouza C, Lopez T, Magro A, Navalpotro L, Amate JM (2006) Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review. Eur Spine J 15:1050–1067PubMedCrossRef Bouza C, Lopez T, Magro A, Navalpotro L, Amate JM (2006) Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review. Eur Spine J 15:1050–1067PubMedCrossRef
15.
go back to reference Taylor RS, Fritzell P, Taylor RJ (2007) Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis. Eur Spine J 16:1085–1100PubMedCrossRef Taylor RS, Fritzell P, Taylor RJ (2007) Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis. Eur Spine J 16:1085–1100PubMedCrossRef
16.
go back to reference Taylor RS, Taylor RJ, Fritzell P (2006) Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety. Spine 31:2747–2755PubMedCrossRef Taylor RS, Taylor RJ, Fritzell P (2006) Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety. Spine 31:2747–2755PubMedCrossRef
17.
go back to reference Wardlaw D, Cummings SR, Van Meirhaeghe J, Bastian L, Tillman JB, Ranstam J, Eastell R, Shabe P, Talmadge K, Boonen S (2009) Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet 373:1016–1024PubMedCrossRef Wardlaw D, Cummings SR, Van Meirhaeghe J, Bastian L, Tillman JB, Ranstam J, Eastell R, Shabe P, Talmadge K, Boonen S (2009) Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet 373:1016–1024PubMedCrossRef
19.
go back to reference Bjelland I, Dahl AA, Haug TT, Neckelmann D (2002) The Validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 52(2):69–77PubMedCrossRef Bjelland I, Dahl AA, Haug TT, Neckelmann D (2002) The Validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 52(2):69–77PubMedCrossRef
20.
go back to reference Blyth CR, Still HA (1983) Binomial confidence intervals. J Am Stat Assoc 78:108–116CrossRef Blyth CR, Still HA (1983) Binomial confidence intervals. J Am Stat Assoc 78:108–116CrossRef
21.
go back to reference Blyth RC (1986) Approximate binomial confidence limits. J Am Stat Assoc 81:843–855CrossRef Blyth RC (1986) Approximate binomial confidence limits. J Am Stat Assoc 81:843–855CrossRef
22.
go back to reference Casella G (1992) Conditional inference from confidence sets. In: Ghosh M, Pathak PK (eds) Current issues in statistical inference: essays in honour of D. Basu. IMS Lecture Notes [3] Casella G (1992) Conditional inference from confidence sets. In: Ghosh M, Pathak PK (eds) Current issues in statistical inference: essays in honour of D. Basu. IMS Lecture Notes [3]
23.
go back to reference Khanna AJ, Reinhardt MK, Togawa D, Lieberman IH (2006) Functional outcomes of kyphoplasty for the treatment of osteoporotic and osteolytic vertebral compression fractures. Osteoporos Int 17:817–826PubMedCrossRef Khanna AJ, Reinhardt MK, Togawa D, Lieberman IH (2006) Functional outcomes of kyphoplasty for the treatment of osteoporotic and osteolytic vertebral compression fractures. Osteoporos Int 17:817–826PubMedCrossRef
24.
go back to reference Garfin SR, Buckley RA, Ledlie J (2006) Balloon kyphoplasty for symptomatic vertebral body compression fractures results in rapid, significant, and sustained improvements in back pain, function, and quality of life for elderly patients. Spine 31:2213–2220PubMedCrossRef Garfin SR, Buckley RA, Ledlie J (2006) Balloon kyphoplasty for symptomatic vertebral body compression fractures results in rapid, significant, and sustained improvements in back pain, function, and quality of life for elderly patients. Spine 31:2213–2220PubMedCrossRef
25.
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 Jt Surg Am 90:1479–1486CrossRef 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 Jt Surg Am 90:1479–1486CrossRef
26.
go back to reference Ledlie JT, Renfro MB (2006) Kyphoplasty treatment of vertebral fractures: 2-year outcomes show sustained benefits. Spine 31:57–64PubMedCrossRef Ledlie JT, Renfro MB (2006) Kyphoplasty treatment of vertebral fractures: 2-year outcomes show sustained benefits. Spine 31:57–64PubMedCrossRef
Metadata
Title
Social implications of balloon kyphoplasty: prospective study from a single UK centre
Authors
Zdenek Klezl
Navjot Bhangoo
Jonathan Phillips
Girish Swamy
Denis Calthorpe
Rajendra Bommireddy
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 9/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-012-2262-7

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