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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-01-2014 | Orthopaedic Surgery

Recompression in new levels after percutaneous vertebroplasty and kyphoplasty compared with conservative treatment

Authors: Xiaodong Yi, Hailin Lu, Fei Tian, Yu Wang, Chunde Li, Hong Liu, Xianyi Liu, Hong Li

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2014

Abstract

Study design

A prospective clinical study assessing new vertebral compression fracture after previous treatment.

Objective

The purpose of this study was to investigate the incidence and associated risk factors of new symptomatic osteoporotic vertebral compression fractures (OVCFs) in patients treated by percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) versus conservative treatment, and to elucidate our findings.

Summary of background data

There are a lot of reports concerning the feasibility and efficacy of this minimally invasive procedure compared with conservative treatment, especially in pain soothing. However, it is still unclear whether the risk of subsequent fracture has increased among operative treatment patients in the long term.

Methods

From November 2005 to July 2009, 290 consecutive patients with 363 OVCFs were randomly selected for PVP/PKP or conservative treatment and evaluated with a mean follow-up of 49.4 months (36–80 months). Some parameters were characterized and statistically compared in this study. Telephone questionnaires, clinical reexamine, and plain radiographs were performed in the follow-up.

Results

Thirty-one of 290 (10.7 %) patients had experienced 42 newly developed symptomatic secondary OVCFs. Among 169 operation (53.3 % vertebroplasty, 46.7 % kyphoplasty) and 121 comparison patients, there is no significant statistical difference of new OVCFs incidence between the two groups calculated by patient proportion. However, in separate, the rate of secondary adjacent fractures calculated by vertebral refracture number is significantly higher than non-adjacent levels in PVP/PKP group but no significant statistical difference was observed in conservative group. The time interval of recompression after operative procedure was much shorter than that for comparison group (9.7 ± 17.8 versus 22.4 ± 7.99 months, p = 0.017). In addition, older age, gender, fracture times, location of original fracture segment, the amount of cement, cement leakage, operation modality (PVP or PKP),and initial number of OVCFs were documented, but these were not the influencing factors in this study (p > 0.05).

Conclusions

Patients who had experienced PVP/PKP were not associated with an increased risk of recompression in new levels. However, recompression in new levels of PVP/PKP group occurred much sooner than that of conservative group in the follow-up period. The incidence of new vertebral fractures observed at adjacent levels was substantially higher but no sooner than at distant levels in PVP/PKP group. No major risk factors involving new OVCFs have been found in this study and augmentation for sandwich situation is not necessary.

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Title: Recompression in new levels after percutaneous vertebroplasty and kyphoplasty compared with conservative treatment
Authors: Xiaodong Yi
Hailin Lu
Fei Tian
Yu Wang
Chunde Li
Hong Liu
Xianyi Liu
Hong Li
Publication date: 01-01-2014
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 1/2014
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-013-1886-3

At a glance: The STEP trials

Springer Medicine

Recompression in new levels after percutaneous vertebroplasty and kyphoplasty compared with conservative treatment

Abstract

Study design

Objective

Summary of background data

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Study design

Objective

Summary of background data

Methods

Results

Conclusions

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