Kyphoplasty and vertebroplasty produce the same degree of height restoration

Abstract

Background and purpose: There are few comparative studies regarding morphologic changes after kyphoplasty and vertebroplasty. The purpose of this study was to compare restoration of vertebral body height and wedge angle and cement leakage with kyphoplasty and vertebroplasty in osteoporotic compression fractures.

Materials and methods: Forty patients (57 vertebrae) were treated with kyphoplasty, and 66 patients (124 vertebrae) were treated with vertebroplasty. Cement leakage into the disk space and paravertebral soft tissues or veins was analyzed on immediate postoperative CT scans. The height and wedge angle were measured before and after treatment and analyzed with the Mann-Whitney U test and chi(2) test.

Results: Kyphoplasty and vertebroplasty both improved vertebral body height and the wedge angles (P < .05). However, these differences were not statistically significant when the 2 techniques were compared (P > .05). There were 18% of the kyphoplasty group and 49% of the vertebroplasty group that showed cement leakage into the paravertebral soft tissues or veins (P < .01). Cement leakage into the disk space occurred in 12% of the kyphoplasty group and in 25% of the vertebroplasty group (P < .01). However, no complications related to cement leakage were noted.

Conclusions: Both kyphoplasty and vertebroplasty achieved the same degree of height restoration and improvement of the wedge angle. Kyphoplasty resulted in less cement leakage into the disk space and paravertebral soft tissues or veins than vertebroplasty.

Fig 1.

A 75-year-old woman with compression fractures at T12 and L1, which were treated with vertebroplasty. A, Postoperative CT scan with sagittal re-formation shows intradiskal cement leakages at L1-L2 disk space (arrow). B, Postoperative axial CT shows cement leakage into the paravertebral vein at T12 on the left (arrow).

Fig 2.

An 85-year-old woman with a compression fracture at L1, which was treated with kyphoplasty. A, Postoperative CT scan with sagittal re-formation shows no intradiskal cement leakage from the L1 vertebral body. B, Postoperative axial CT scan again shows no cement leakage from the L1 vertebral body.