Kyphoplasty with intravertebral reduction devices associated with better height restoration and greater kyphosis correction than kyphoplasty with balloons

Chi-Jung Chiang,Jin-Wei Huang,Shu-Mei Chen,Jiann-Her Lin

doi:10.1038/s41598-021-84856-9

Abstract

Kyphoplasty (KP) with intravertebral reduction devices (IRD) was reported to be associated with better radiological outcomes than KP with balloons (BK) for osteoporotic vertebral compression fractures (OVCFs). However, the mechanical factors that contribute to the radiological benefits of IRDs require further investigation. To probe the mechanical factors, this retrospective matched cohort study was designed, including the older patients with painful OVCFs and treated with KP. We compared the clinical and radiological outcomes between KP with an IRD and BK, where vertebral body height and kyphotic angle of the cemented vertebrae were measured pre- and postoperatively; clinical outcomes were collected by telephone interviews. The restoration and maintenance ratio suggested that IRDs were associated with favorable effects long-term wise in anterior to middle vertebral body and kyphosis than BK in patients. The gathered results concluded the radiological benefits of IRD regarding both its efficient restoration and maintenance in vertebrae.

Highlights

Kyphoplasty (KP) with intravertebral reduction devices (IRD) was reported to be associated with better radiological outcomes than KP with balloons (BK) for osteoporotic vertebral compression fractures (OVCFs)
IRD has been demonstrated to be associated with superior body height restoration and kyphotic angle correction compared with VP8
Patients were included if they were older than 60 years; presented with focal back pain and/or lower extremities pain; diagnosed as having OVCFs with an apparent bone edema in the fractured site using MRI T2-weighted short tau inversion recovery resonance or using an enhanced area within the vertebral body in MRI-contrast T1-weighted sequences; presented with clinical symptoms corresponding to the locations of the OVCFs

Summary

Introduction

Kyphoplasty (KP) with intravertebral reduction devices (IRD) was reported to be associated with better radiological outcomes than KP with balloons (BK) for osteoporotic vertebral compression fractures (OVCFs). We compared the clinical and radiological outcomes between KP with an IRD and BK, where vertebral body height and kyphotic angle of the cemented vertebrae were measured pre- and postoperatively; clinical outcomes were collected by telephone interviews. IRD has been demonstrated to be associated with superior body height restoration and kyphotic angle correction compared with VP8. Compared with BK, IRD reportedly resulted in significantly enhanced body height restoration in a human cadaveric study[9]. Another prospective comparative study by Noriega et al demonstrated the significant radiological benefits of IRD in 15 p atients[10]. The purpose of the present duo-center retrospective study was to evaluate the radiological and clinical benefits of IRD over BK with a relatively large sample size and to investigate whether the radiological advantages arise from the restoration effect or the maintenance effect, or both

Methods

Results

Conclusion