Background: Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) are established methods in the treatment of vertebral compression fractures (VCFs). In our manuscript, the target was to evaluate the efficacy of PVPs/PKPs and to determine the implications of potential periprocedural complications. Methods: 280 patients, specifically 194 women (69.3%) and 86 men (30.7%), were enrolled. We used the AO spine fractures classification and the Yeom classification to determine the subtype of cement leakage. Only single-level VCFs of the thoracic or lumbar spine were included. Visual analogue scale (VAS) was assessed preoperatively and regularly after the surgery. Vertebral compression ratio (VBCR) was used to determine postoperative vertebral body collapse. Results: We recorded 54 cases (19.3%) of cement leakage. There was a significant decrease in mean VAS scores (6.82-0.76 in PVPs, 7.15-0.81 in PKPs). The decrease in VBCR was greater in the VP group (4.39%; 84.21-79.82) compared to the KP group (1.95%; 74.36-72.41). Conclusions: No significant difference in the risk of cement leakage when comparing KPs and VPs was found. VPs and KPs provide rapid and significant pain relief in patients with VCFs. Clinically relevant complications of VPs and KPs are rare. Kyphoplasties prevent further vertebral body collapse more effectively compared to vertebroplasties.

Department of Mathematics Faculty of Science Jan Evangelista Purkyne University in Usti nad Labem 400 96 Usti nad Labem Czech Republic

Department of Orthopaedic Surgery Faculty of Medicine in Hradec Kralove Charles University 500 03 Hradec Kralove Czech Republic

Department of Orthopaedics Faculty of Health Studies Jan Evangelista Purkyne University in Usti nad Labem and Masaryk Hospital 401 13 Usti nad Labem Czech Republic

Department of Rehabilitation and Sports Medicine 2nd Faculty of Medicine Charles University and University Hospital Motol 150 06 Prague Czech Republic

See more in PubMed

Divi S.N., Schroeder G.D., Oner F.C., Kandziora F., Schnake K.J., Dvorak M.F., Benneker L.M., Chapman J.R., Vaccaro A.R. AO Spine-Spine Trauma Classification System: The Value of Modifiers: A Narrative Review with Commentary on Evolving Descriptive Principles. Glob. Spine J. 2019;9((Suppl. S1)):77S–88S. doi: 10.1177/2192568219827260. PubMed DOI PMC

Kushchayev S.V., Wiener P.C., Teytelboym O.M., Arrington J.A., Khan M., Preul M.C. Percutaneous Vertebroplasty: A History of Procedure, Technology, Culture, Specialty, and Economics. Neuroimaging Clin. N. Am. 2019;29:481–494. doi: 10.1016/j.nic.2019.07.011. PubMed DOI

Tomé-Bermejo F., Piñera A.R., Duran-Álvarez C., Román B.L., Mahillo I., Alvarez L., Pérez-Higueras A. Identification of Risk Factors for the Occurrence of Cement Leakage During Percutaneous Vertebroplasty for Painful Osteoporotic or Malignant Vertebral Fracture. Spine. 2014;39:E693–E700. doi: 10.1097/BRS.0000000000000294. PubMed DOI

Filippiadis D.K., Marcia S., Masala S., Deschamps F., Kelekis A. Percutaneous Vertebroplasty and Kyphoplasty: Current Status, New Developments and Old Controversies. Cardiovasc. Interv. Radiol. 2017;40:1815–1823. doi: 10.1007/s00270-017-1779-x. PubMed DOI

Noguchi T., Yamashita K., Kamei R., Maehara J. Current status and challenges of percutaneous vertebroplasty (PVP) Jpn. J. Radiol. 2023;41:1–13. doi: 10.1007/s11604-022-01322-w. PubMed DOI PMC

Cao J., Kong L., Meng F., Zhang Y., Shen Y. Risk factors for new vertebral compression fractures after vertebroplasty: A meta-analysis. ANZ J. Surg. 2016;86:549–554. doi: 10.1111/ans.13428. PubMed DOI

Telera S., Raus L., Pipola V., De Iure F., Gasbarrini A. Vertebral Body Augmentation, Vertebroplasty and Kyphoplasty in Spine Surgery. Springer; Cham, Switzerland: 2021. DOI

Hsu W.E., Su K.C., Chen K.H., Pan C.C., Lu W.H., Lee C.H. The Evaluation of Different Radiological Measurement Parameters of the Degree of Collapse of the Vertebral Body in Vertebral Compression Fractures. Appl. Bionics Biomech. 2019;2019:4021640. doi: 10.1155/2019/4021640. PubMed DOI PMC

Rebolledo B.J., Gladnick B.P., Unnanuntana A., Nguyen J.T., Kepler C.K., Lane J.M. Comparison of unipedicular and bipedicular balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures. Bone Jt. J. 2013;95:401–406. doi: 10.1302/0301-620X.95B3.29819. PubMed DOI

Lee C.H., Kim H.J., Lee M.K., Kim H.S., Choi S.S. Comparison of efficacies of unipedicular kyphoplasty and bipedicular kyphoplasty for treatment of single-level osteoporotic vertebral compression fractures. Medicine. 2020;99:e22046. doi: 10.1097/MD.0000000000022046. PubMed DOI PMC

Yan L., Jiang R., He B., Liu T., Hao D. A Comparison Between Unilateral Transverse Process-Pedicle and Bilateral Puncture Techniques in Percutaneous Kyphoplasty. Spine. 2014;39:B19–B26. doi: 10.1097/BRS.0000000000000493. PubMed DOI

Son S., Lee S.G., Kim W.K., Park C.W., Yoo C.J. Early Vertebroplasty versus Delayed Vertebroplasty for Acute Osteoporotic Compression Fracture: Are the Results of the Two Surgical Strategies the Same? J. Korean Neurosurg. Soc. 2014;56:211–217. doi: 10.3340/jkns.2014.56.3.211. PubMed DOI PMC

Liu D., Xu J., Wang Q. Timing of Percutaneous Balloon Kyphoplasty for Osteoporotic Vertebral Compression Fractures. Pain Physician. 2023;26:231–243. PubMed

Zhang J., Fan Y., He X., Du J., Hao D. Bracing after percutaneous vertebroplasty for thoracolumbar osteoporotic vertebral compression fractures was not effective. Clin. Interv. Aging. 2019;14:265–270. doi: 10.2147/CIA.S192821. PubMed DOI PMC

Guo X., Zhu N., Zhang H., Hao D. Vertebral refracture after percutaneous vertebroplasty for osteoporotic vertebral compression fractures with and without brace wearing: A retrospective study of 300 patients. Front. Surg. 2023;9:1056729. doi: 10.3389/fsurg.2022.1056729. PubMed DOI PMC

Kato T., Inose H., Ichimura S., Tokuhashi Y., Nakamura H., Hoshino M., Togawa D., Hirano T., Haro H., Ohba T., et al. Comparison of Rigid and Soft-Brace Treatments for Acute Osteoporotic Vertebral Compression Fracture: A Prospective, Randomized, Multicenter Study. J. Clin. Med. 2019;8:198. doi: 10.3390/jcm8020198. PubMed DOI PMC

Li Z., Liu T., Yin P., Wang Y., Liao S., Zhang S., Su Q., Hai Y. The therapeutic effects of percutaneous kyphoplasty on osteoporotic vertebral compression fractures with or without intravertebral cleft. Int. Orthop. 2019;43:359–365. doi: 10.1007/s00264-018-4007-7. PubMed DOI

Zhu S.Y., Zhong Z.M., Wu Q., Chen J.T. Risk factors for bone cement leakage in percutaneous vertebroplasty: A retrospective study of four hundred and eighty five patients. Int. Orthop. 2016;40:1205–1210. doi: 10.1007/s00264-015-3102-2. PubMed DOI

Liu J.T., Li C., Chang C.S., Liao W.J. Long-term follow-up study of osteoporotic vertebral compression fracture treated using balloon kyphoplasty and vertebroplasty. J. Neurosurg. Spine. 2015;23:94–98. doi: 10.3171/2014.11.SPINE14579. PubMed DOI

de Falco R., Bocchetti A. Balloon kyphoplasty for pure traumatic thoracolumbar fractures: Retrospective analysis of 61 cases focusing on restoration of vertebral height. Eur. Spine J. 2014;23((Suppl. S6)):664–670. doi: 10.1007/s00586-014-3548-8. PubMed DOI

Bonnard E., Foti P., Kastler A., Amoretti N. Percutaneous vertebroplasty under local anaesthesia: Feasibility regarding patients’ experience. Eur. Radiol. 2017;27:1512–1516. doi: 10.1007/s00330-016-4521-1. PubMed DOI

Li Y.X., Guo D.Q., Zhang S.C., Liang D., Yuan K., Mo G.Y., Li D.X., Guo H.Z., Tang Y., Luo P.J. Risk factor analysis for re-collapse of cemented vertebrae after percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) Int. Orthop. 2018;42:2131–2139. doi: 10.1007/s00264-018-3838-6. PubMed DOI

Seuvic F.M., Gillet R., Louis M., Germain É., Lombard C., Blum A., Gondim Teixeira P.A. Association between opportunistic vertebral bone density measurements and new vertebral fractures after percutaneous vertebral cementoplasty: A case-control study. Eur. Radiol. 2023;33:106–115. doi: 10.1007/s00330-022-08946-6. PubMed DOI

Schousboe J.T., Lix L.M., Morin S.N., Derkatch S., Bryanton M., Alhrbi M., Leslie W.D. Prevalent vertebral fracture on bone density lateral spine (VFA) images in routine clinical practice predict incident fractures. Bone. 2019;121:72–79. doi: 10.1016/j.bone.2019.01.009. PubMed DOI

Saracen A., Kotwica Z. Complications of percutaneous vertebroplasty. Medicine. 2016;95:e3850. doi: 10.1097/MD.0000000000003850. PubMed DOI PMC

Wang C.H., Ma J.Z., Zhang C.C., Nie L. Comparison of high-viscosity cement vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures. Pain Physician. 2015;18:E187–E194. PubMed

The Effectiveness and Practical Application of Different Reduction Techniques in Burst Fractures of the Thoracolumbar Spine