Early clinical outcome of vesselplasty and kyphoplasty in treatment of osteoporotic vertebral compression fractures

Abstract

Objective To compare the early clinical outcomes of vesselplasty and kyphoplasty in the treatment of osteoporotic vertebral compression fractures. Methods A retrospective analysis was performed in 114 patients with OVCFs underwent vesselplasty (59 cases, 68 vertebras) and kyphoplasty (55 cases, 66 vertebras) in Hangzhou Normal University affiliated Hospital between June 2015 to December 2016. Preoperative vertebral compression, vertebral height restoration, cement leakage, the shape of cement, the volume ratio of cement were compared between two groups. The Clinical effect were evaluated using the visual analogue scale (VAS) and Oswestry disability index (ODI). Results All 57 cases received an average of (3.7±0.9) months follow-up (3-6 months). Compared with preoperative data, VAS and ODI score were improved significantly at 1 day after operation in both groups (PKP: Z=-10.143, F=1768.418, P<0.05; vesselplasty: Z=-10.027, F=2192.838, P<0.05). And at the last follow-up, the VAS and ODI score were improved significantly compared to the postoperative 1 day after operation in both groups (PKP: Z=-5.708, F=204.339, P<0.05; vesselplasty: Z=-5.691, F=147.729, P<0.05). PKP group associated with a higher rate of cement leakage than the vesselplasty group (27.9% vs. 13.6%, χ2=4.146, P<0.05) and a lower rate of cement volume ratio [(22±5)% vs. (24±4)%, t=-2.659, P<0.05]. In the aspect of cement shape, the dominant one in PKP group were mixed type (60.3%) and trabecular type (39.7%), while the vesselplasty group were mixed type (78.8%) and mass type (15.1%), the difference had statistically significant (χ2=34.271, P<0.05). Four patients (1 case in PKP group and 3 cases in vesselplasty group) had vertebra fractures during the follow-up period, the inter-group comparison has no significant differences. Conclusions Vesselplasty can rapidly relieve pain, improve mobility, restore the height of vertebral in patients with OVCFs. It is suitable for complex vertebral fractures as reducing the incidence of cement leakage contrasting to PKP. Key words: Osteoporosis; Fractures, compression; Kyphoplasty; Bone filling mesh-container