Review Article

Controversial Issues in Kyphoplasty and Vertebroplasty in Osteoporotic Vertebral Fractures

Table 1


Author/year of publicationBaseline characteristicsPain reliefDisabilityQoLKyphotic angle/VH Cement leakageNew fracturesConclusion

(1) Wardlaw et al. 2009 [22], Boonen et al. 2011 [27]
(FREE)
RCT
(1) BKP (149) versus NSM (151)
(2) Acute number
(3) 1 mo, 3 mo, 6 mo, 12 mo
VAS score  
BKP superior to NSM( )
RM  
BKP superior to NSM
SF-36
BKP superior to NSM
EQ-5D
BKP superior to NSM
NR 27%, none symptomaticBKP: 33%  
NSM: 25%   : NR
BKP is superior to NSM in acute VCFs in terms of pain and QOL/disability. Differences between groups diminished by 1 year.

(2) Liu et al. 2010 [44]
RCT
(1) BKP (50) versus VP (50)
(2) Acute number
(3) Postop, 6 mo
VAS score  
BKP equivalent to VP
NRNRBKP superior to VP ( ) NRBKP: 2  
VP: 0
Similar clinical results between BKP and VP. Better height restoration with BKP.

(3) Rousing et al. 2009 [11], 2010 [12]
RCT
(1) VP (26) versus NSM (24)  
(2) Acute number
(3) 3 mo, 12 mo
VAS score  
VP equivalent to NSM up to 1 y ( )
NRSF36  
VP equivalent to NSM up to 1 y
NRNRVP/NSM:  
RR: 1.3
No difference between VP and NSM in 3 months and 12 months

(4) Voormolen et al. 2007 (VERTOS I) [21]
RCT
(1) VP (18) versus NSM (16)  
(2) Acute number
(3) Postop, 2 w
VAS score  
VP superior to NSM 14/16 pts crossovered from NSM to VP  
RM  
VP superior to NSM
QUALEFFO  
Mixed results in the subscores between groups
NRNRNRVP is more effective than NSM in pain relief and function in the immediate postop period (2 weeks)

(5) Buchbinder et al. 2009 [4]
RCT—SHAM group
(1) VP (38) versus SHAM (40)  
(2) Acute number  (also subacute)
(3) 1 w, 1 mo, 3 mo, 6 mo
VAS score  
VP equivalent to SHAM
RM  
VP equivalent to SHAM
AQoL, QUALEFFO, EQ-5D  
VP equivalent to SHAM
NR37%, none symptomaticVP: 3  
SHAM: 4
No difference between VP and SHAM up to 6 months

(6) Kallmes et al. 2009 (INVEST) [5]
RCT—SHAM group
(1) VP (68) versus SHAM (63)  
(2) Subacute number(also Acute and Chronic)
(3) Postop, 2 w, 1 mo, 3 mo
VAS score  
VP equivalent to SHAM Higher crossover rate in SHAM ( )
RM  
VP equivalent to SHAM ( )
EQ-5D, SF-36  
VP equivalent to SHAM
NRNRNRNo difference between VP and SHAM up to 1 month

(7) Klazen et al. 2010 (VERTOS II) [19]
RCT
(1) VP (101) versus NSM (101)  
(2) Acute number
(3) Postop, 1 w, 1 mo, 3 mo, 6 mo, 1 y
VAS score  
VP superior to NSM
( )
RM  
VP superior to NSM
( )
QUALEFFO, EQ-5D  
VP superior to NSM
( )
NR72% had asymptomatic cement leakageVP equivalent to NSM ( )VP is more effective than NSM in acute fractures for at least 1 year.

(8) Endres and Badura 2012 [38]RCTBKP versus UNI BKP versus VPAll equivalentAll equivalentVP more cement leakVP procedure of choice due to less time and RT (but cement leak)

(9) Vogl et al. 2013 [45]
RCT
KP-CD (49) versus VP (28) equivalentVP more cement leak3 in VP, 2 in KPKP-CD reduces posterior cement leak