Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2021; 9(31): 9509-9519
Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9509
Outcomes of different minimally invasive surgical treatments for vertebral compression fractures: An observational study
Kuei-Lin Yeh, Szu-Hsien Wu, Chen-Kun Liaw, Sheng-Mou Hou, Shing-Sheng Wu
Kuei-Lin Yeh, Sheng-Mou Hou, Shing-Sheng Wu, Department of Orthopedics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 11101, Taiwan
Szu-Hsien Wu, Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei 11217, Taiwan
Chen-Kun Liaw, Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
Chen-Kun Liaw, Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
Chen-Kun Liaw, Graduate Institute of Biomedical Optomechatronics, College of Biomedical Engineering, Research Center of Biomedical Device, Taipei Medical University, Taipei 11301, Taiwan
Author contributions: Yeh KL contributed to the study design and interpretation of the data; Wu SH and Liaw CK contributed to the acquisition and analysis of the data, and the creation of new software used in the work; Wu SS assisted in the interpretation of data and drafted the work; Hou SM contributed to the acquisition and analysis of the data and drafted the work.
Institutional review board statement: The study was approved by the institutional review board of Shin-Kong Wu Ho-Su Memorial Hospital, Taiwan (Approval No. 20200608R).
Informed consent statement: The requirement for written consent was waived owing to the retrospective study design.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: The data supporting the findings of this study are available within the article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shing-Sheng Wu, MSc, Professor, Department of Orthopedics, Shin Kong Wu Ho-Su Memorial Hospital, No. 95 Wenchang Road, Shilin District, Taipei 11101, Taiwan. raysswu@gmail.com
Received: July 12, 2021
Peer-review started: July 12, 2021
First decision: August 18, 2021
Revised: August 31, 2021
Accepted: September 8, 2021
Article in press: September 8, 2021
Published online: November 6, 2021
Abstract
BACKGROUND

Osteoporosis with vertebral compression fractures is increasingly common in the elderly population. Cement augmentation is one of the effective surgical treatments for these patients. Currently, there are several different types of cement augmentation treatments. No studies have compared the safety and efficacy of different cement augmentation types for the treatment of such fractures; thus, we retrospectively compared vertebroplasty, balloon kyphoplasty, and kyphoplasty with SpineJack or an intravertebral expandable pillar.

AIM

To compare the postoperative safety and efficacy of each surgical intervention in treating vertebral compression fractures.

METHODS

We retrospectively analyzed 354 patients with acute vertebral compression fractures, defined as signal changes in the T1 weighted magnetic resonance imaging, and randomly divided the patients into five groups. Their visual analog scale scores for pain, kyphotic angle, average body height, rate of cement leakage, and occurrence of adjacent vertebral compression fractures were followed for 1 year. One-way analysis of variance, the post hoc Bonferroni test, and Fisher exact probability test were used for statistical analyses.

RESULTS

All pain scores significantly improved 12 mo postoperatively; however, there was no significant difference between the groups (P = 0.325). Kyphoplasty with SpineJack significantly reduced the kyphotic angle (P = 0.028) and restored the height of the vertebral body (P = 0.02). The rate of adjacent compression fractures was the highest in the vertebroplasty group, with a statistically significant difference according to the Fisher exact probability test (P = 0.02). The treatment with the lowest cement leakage rate cannot be identified because of the small sample size; however, kyphoplasty with SpineJack, an IVEP, and vesselplasty resulted in lower rates of cement leakage than balloon kyphoplasty and vertebroplasty.

CONCLUSION

Kyphoplasty with SpineJack has good outcomes in kyphotic angle reduction and body height restoration. Vertebroplasty has the highest cement leakage rate and adjacent compression fracture occurrence.

Keywords: Vertebral compression fracture, Vertebroplasty, Kyphoplasty, Osteoporosis, Observational study

Core Tip: The outcomes of different surgical treatments for vertebral compression fractures are discussed in this study. Kyphoplasty with SpineJack was found to have the best kyphotic angle reduction, body height restoration, and rate of cement leakage. Nevertheless, vertebroplasty was associated with the highest rate of cement leakage and adjacent compression fracture occurrence. There was no significant difference between each surgical group in terms of pain relief, which was quantified using visual analog scale scores.