Kyphoplasty versus vertebroplasty in osteoporotic thoracolumbar spine fractures. Short-term retrospective review of a multicentre cohort of 127 consecutive patients - 25/09/12
, J. Tonetti a, A. Bodin a, H. Vouaillat a, P. Merloz a, R. Assaker b, C. Court cthe French Society for Spine Surgery1
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Summary |
Background |
Osteoporotic spine fractures induce a heavy burden in terms of both general health and healthcare costs. The objective of this multicentre study by the French Society for Spine Surgery (SFCR) was to compare outcomes after vertebroplasty and kyphoplasty in the treatment of osteoporotic thoracolumbar vertebral fractures.
Hypothesis |
We hypothesised that differences existed between vertebroplasty and kyphoplasty, notably regarding operative time and reduction efficacy, from which criteria for patient selection might be inferred.
Material and methods |
We conducted a retrospective multicentre review of 127 patients with Magerl Type A low-energy fractures after a fall from standing height between 2007 and 2010; 85 were managed with vertebroplasty and 42 with kyphoplasty. Age was not a selection criterion. We recorded pain intensity, time to management, operative time, kyphosis angle, wedge angle, cement leakage rate, and degree of cement filling.
Results |
Operative time was 43minutes with kyphoplasty and 24minutes with vertebroplasty (P=0.0002). Both techniques relieved pain, with no significant difference. Kyphoplasty significantly improved the wedge angle, by +6°, versus +2° with vertebroplasty (P=0.002). With kyphoplasty, the volume injected was larger and cement distribution was less favourable. Leakage rates were similar.
Discussion |
Despite the heterogeneity of our study, our data confirm the effectiveness of kyphoplasty in alleviating pain and decreasing deformities due to osteoporotic vertebral fractures. Vertebroplasty is a faster and less costly procedure that remains useful; no detectable clinical complications occur with vertebroplasty, which ensures better anchoring of the cement in the cancellous bone.
Level of evidence |
Level 4, retrospective cohort study.
Le texte complet de cet article est disponible en PDF.Keywords : Spine fractures, Osteoporosis, Vertebroplasty, Kyphoplasty
Plan
Vol 98 - N° 6S
P. S112-S119 - octobre 2012 Retour au numéro
Article précédent
- Minimally invasive management of thoraco-lumbar fractures: Combined percutaneous fixation and balloon kyphoplasty
- F. Zairi, C. Court, P. Tropiano, Y.P. Charles, J. Tonetti, S. Fuentes, S. Litrico, H. Deramond, J. Beaurain, P. Orcel, J. Delecrin, M. Aebi, R. Assaker, the French Society of Spine Surgery 1
- One-stage bilateral total hip arthroplasty: Functional outcomes and complications in 112 patients
- C. Trojani, T. d’Ollonne, D. Saragaglia, C. Vielpeau, M. Carles, J.-L. Prudhon, the French Society for the Hip and Knee (SFHG) 1
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