A Comprehensive Analysis of Vertebroplasty and Kyphoplasty for Osteoporotic Vertebral Compression Fractures and Postoperative Sagittal Balance.

IF 1.1 4区医学 Q3 ORTHOPEDICS

Indian Journal of Orthopaedics Pub Date : 2025-06-10 eCollection Date: 2025-08-01 DOI:10.1007/s43465-025-01438-x

Mehmet Yigit Akgun, Ege Anil Ucar, Gumral Mamedova, Tunc Oktenoglu, Ozkan Ates, Ali Fahir Ozer

{"title":"A Comprehensive Analysis of Vertebroplasty and Kyphoplasty for Osteoporotic Vertebral Compression Fractures and Postoperative Sagittal Balance.","authors":"Mehmet Yigit Akgun, Ege Anil Ucar, Gumral Mamedova, Tunc Oktenoglu, Ozkan Ates, Ali Fahir Ozer","doi":"10.1007/s43465-025-01438-x","DOIUrl":null,"url":null,"abstract":"Background: Osteoporotic vertebral compression fractures (OVCFs) lead to posture restrictions, back muscle fatigue, difficulty walking, impaired lung function, an increased risk of disability, and severe pain. Collectively, these symptoms significantly diminish patients' quality of life. While non-surgical management is often attempted, it may prove inadequate for cases involving walking difficulties and sagittal imbalance. In such instances, surgical interventions like vertebroplasty (VP) and kyphoplasty (KP) become necessary. To our knowledge, no study in the literature has directly compared VP and KP in terms of their effectiveness in improving sagittal balance.Aim: This study aims to compare the clinical and radiological outcomes of VP and KP, with a specific focus on their impact on global spinal alignment and sagittal balance.Methods: Seventy-six patients with OVCFs (mean age: 64.12 ± 11.85 years) underwent either kyphoplasty (59%) or vertebroplasty (41%). Radiological parameters, clinical outcomes, operation time, and complications were evaluated at 6-month, 12-month, and 24-month follow-ups. The improvement in sagittal balance was compared between the KP and VP groups.Results: Only KP significantly increased vertebral height, though no significant postoperative differences in vertebral height were observed between the KP and VP groups. Similarly, KP was the only procedure that improved thoracic kyphosis in OVCF patients. Neither VP nor KP demonstrated significant improvement in sagittal balance, including pelvic parameters and the sagittal vertical axis. However, both groups showed marked pain relief, as evaluated by the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Complication rates were low in both groups, and there was no significant difference in the incidence of cement leakage.Conclusion: While both KP and VP demonstrated efficacy in treating OVCFs, neither procedure showed clear superiority in terms of pain relief, sagittal balance, or complication rates. However, only KP significantly increased vertebral height and improved thoracic kyphosis in OVCF patients.Supplementary information: The online version contains supplementary material available at 10.1007/s43465-025-01438-x.","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1219-1226"},"PeriodicalIF":1.1000,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367588/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s43465-025-01438-x","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Osteoporotic vertebral compression fractures (OVCFs) lead to posture restrictions, back muscle fatigue, difficulty walking, impaired lung function, an increased risk of disability, and severe pain. Collectively, these symptoms significantly diminish patients' quality of life. While non-surgical management is often attempted, it may prove inadequate for cases involving walking difficulties and sagittal imbalance. In such instances, surgical interventions like vertebroplasty (VP) and kyphoplasty (KP) become necessary. To our knowledge, no study in the literature has directly compared VP and KP in terms of their effectiveness in improving sagittal balance.

Aim: This study aims to compare the clinical and radiological outcomes of VP and KP, with a specific focus on their impact on global spinal alignment and sagittal balance.

Methods: Seventy-six patients with OVCFs (mean age: 64.12 ± 11.85 years) underwent either kyphoplasty (59%) or vertebroplasty (41%). Radiological parameters, clinical outcomes, operation time, and complications were evaluated at 6-month, 12-month, and 24-month follow-ups. The improvement in sagittal balance was compared between the KP and VP groups.

Results: Only KP significantly increased vertebral height, though no significant postoperative differences in vertebral height were observed between the KP and VP groups. Similarly, KP was the only procedure that improved thoracic kyphosis in OVCF patients. Neither VP nor KP demonstrated significant improvement in sagittal balance, including pelvic parameters and the sagittal vertical axis. However, both groups showed marked pain relief, as evaluated by the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Complication rates were low in both groups, and there was no significant difference in the incidence of cement leakage.

Conclusion: While both KP and VP demonstrated efficacy in treating OVCFs, neither procedure showed clear superiority in terms of pain relief, sagittal balance, or complication rates. However, only KP significantly increased vertebral height and improved thoracic kyphosis in OVCF patients.

Supplementary information: The online version contains supplementary material available at 10.1007/s43465-025-01438-x.

查看原文本刊更多论文

椎体成形术和后凸成形术治疗骨质疏松性椎体压缩性骨折及术后矢状位平衡的综合分析。

背景：骨质疏松性椎体压缩性骨折（OVCFs）导致姿势限制、背部肌肉疲劳、行走困难、肺功能受损、残疾风险增加和严重疼痛。总的来说，这些症状显著降低了患者的生活质量。虽然非手术治疗经常被尝试，但对于行走困难和矢状面不平衡的病例可能是不够的。在这种情况下，手术干预，如椎体成形术（VP）和后凸成形术（KP）是必要的。据我们所知，文献中没有研究直接比较VP和KP在改善矢状面平衡方面的有效性。目的：本研究旨在比较VP和KP的临床和影像学结果，特别关注它们对脊柱整体对齐和矢状面平衡的影响。方法：76例ovcf患者（平均年龄：64.12±11.85岁）行后凸成形术（59%）或椎体成形术（41%）。在随访6个月、12个月和24个月时评估影像学参数、临床结果、手术时间和并发症。比较KP组和VP组矢状面平衡的改善情况。结果：只有KP显著增加了椎体高度，但KP组和VP组术后椎体高度无明显差异。同样，KP是唯一能改善OVCF患者胸后凸的手术。VP和KP均未显示出矢状面平衡的显著改善，包括骨盆参数和矢状面垂直轴。然而，通过视觉模拟量表（VAS）和Oswestry残疾指数（ODI）评估，两组均表现出明显的疼痛缓解。两组术后并发症发生率均较低，水泥渗漏发生率无显著差异。结论：虽然KP和VP在治疗OVCFs方面都有疗效，但在疼痛缓解、矢状面平衡或并发症发生率方面，两者都没有明显的优势。然而，只有KP能显著增加OVCF患者的椎体高度和改善胸后凸。补充资料：在线版本包含补充资料，下载地址为10.1007/s43465-025-01438-x。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Indian Journal of Orthopaedics ORTHOPEDICS-

CiteScore

1.80

自引率

0.00%

发文量

185

审稿时长

9 months

期刊介绍： IJO welcomes articles that contribute to Orthopaedic knowledge from India and overseas. We publish articles dealing with clinical orthopaedics and basic research in orthopaedic surgery. Articles are accepted only for exclusive publication in the Indian Journal of Orthopaedics. Previously published articles, articles which are in peer-reviewed electronic publications in other journals, are not accepted by the Journal. Published articles and illustrations become the property of the Journal. The copyright remains with the journal. Studies must be carried out in accordance with World Medical Association Declaration of Helsinki.