Comparison of vertebroplasty and kyphoplasty in the treatment of osteoporotic vertebral compression fractures with intravertebral clefts

Abstract

Few studies have compared the surgical outcomes of vertebroplasty (VP) and kyphoplasty (KP) in the treatment of osteoporotic vertebral compression fractures (VCFs) with intravertebral clefts. A retrospective study was conducted to review patients with a single-level osteoporotic VCF treated by VP or KP. Intravertebral clefts were assessed by preoperative computed tomography (CT) and magnetic resonance scans. All enrolled patients were followed up for 12months. Clinical outcomes, radiological findings and complications were evaluated. A total of 53 patients were available for data analysis. Most of the fractures (75.5%) occurred in the region of the thoracolumbar junction (T10-L2). Twenty-four patients received VP and 29 patients received KP. Patients in both group had significant pain relief after surgery (P<0.01). Compared with VP group, there was a significant lower visual analogue scale (VAS) score in KP group at the 6- (P=0.04) and 12-month follow-up (P=0.02), but the decreased values of VAS score had no significant correlation with the magnitude of deformity correction. Restoration of vertebral body height and reduction in kyphotic angle were achieved in both groups, and the magnitude of correction was more significant in KP group (P<0.01). Cement leakage rate in VP group (66.7%) was higher than that in KP group (20.7%), and there was a significant difference (P<0.01). Intravertebral clefts occur primarily at the thoracolumbar junction and can be detected easily by CT and magnetic resonance imaging scans. Both VP and KP are effective in the treatment of clefts, but patients in KP group tend to have a better pain relief at the medium and long-term follow-up. However, the better pain relief effect of KP cannot be attributed to the higher magnitude of deformity correction.