Osteoporotic compression fractures (OVCFs) commonly occur in aged people, and as much as one-third of these fractures progress to chronic pain. Kyphoplasty (KP) is proved to be efficacious for pain relief and vertebral height restoration in chronic OVCFs, but there is still no data available about the clinical and radiographical outcomes compared by unipedicular and bipedicular KP in treating chronic painful OVCFs.
To assess the clinical and radiographical outcomes in treating chronic painful OVCFs compared by unipedicular and bipedicular KP.
Fifty-eight patients with a total of sixty-six chronic painful OVCFs were enroled in our study. They were randomly allocated into two groups: group I (n = 33) was treated with unipedicular KP and group II (n = 25) with bipedicular KP. The operation times for each group were recorded and compared. Preoperative and postoperative of visual analogue scores (VAS) and oswestry disability index (ODI) scores were compared 2 weeks after surgery within each group and between groups. The radiographic outcomes were evaluated by the restoration rate (RR) in the most compressed point of the vertebral bodies.
Significant improvement on the VAS, ODI scores and RR was noted in each group (p < 0.001), and there is no significant difference existing in clinical outcomes between the two groups. The mean operation time for each vertebra in group I was significantly shorter than in group II (p < 0.001). But the RR in group II was higher than in group I (p = 0.041).
Both unipedicular kyphoplasty and bipedicular kyphoplasty can achieve satisfactory clinical and radiographic outcomes in treating the chronic painful OVCFs and the operation time is shorter in unipedicular kyphoplasty. However, the bipedicular kyphoplasty is more efficacious in height restoration.
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- Kyphoplasty for treatment of osteoporotic vertebral fractures: a prospective nonrandomized study.Eur Spine J. 2004; 13: 496-501
- Consensus development conference: prophylaxis and treatment of osteoporosis.AM J Med. 1991; 90: 107-110
- Treatment of chronic symptomatic vertebral compression fractures with percutaneous vertebroplasty.AJR. 2004; 182: 319-322
- Acute versus chronic vertebral compression fractures treated with kyphoplasty: early results.Spine J. 2004; 4: 418-424
- Percutaneous vertebroplasty.Semin Musculoskelet Radiol. 1997; 1: 107-110
- Vertebral compression fractures: pain reduction and improvement in functional mobility after percutaneous polymethylmethacrylate vertebroplasty—retrospective report of 245 cases.Radiology. 2003; 226: 366-372
- New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures.Spine. 2001; 26: 1511-1515
- Percutaneous vertebroplasty in the treatment of osteoporotic compression fractures.Neuroimaging Clin N Am. 2000; 10: 547-568
- Age of fracture and clinical outcomes of percutaneous vertebroplasty.AJNR. 2001; 22: 1860-1863
- Distribution of anterior cortical shear strain after a thoracic wedge compression fracture.Spine J. 2004; 4: 76-87
- Balloon kyphoplasty: one-year outcomes in vertebral body height restoration, chronic pain, and activity levels.J Neurosurg. 2003; 98: 36-42
- The osteoporotic spine.Clin Orthop Relat Res. 1996; 323: 91-97
- Metastatic compression fractures—vertebroplasty for pain control.J Neurosci Nurs. 2004; 35: 500-555
- Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures.Spine. 2001; 26: 1631-1638
- Vertebral fractures in Beijing, China: The Beijing osteoporosis project.J Bone Miner Res. 2000; 15: 2019-2025
- Association of osteoporotic vertebral compression fractures with impaired function status.Am J Med. 1993; 94: 595-601
- The natural history of the osteoporotic vertebral fracture.Clin Rheumatol. 1989; 8: 66-69
- The association of radiographically detected vertebral fractures with back pain and function: a prospective study.Ann Intern Med. 1998; 128: 793-800
- Diagnosis and management of vertebral fractures in elderly adults.Am J Med. 2002; 113: 220-228
- Early radiographic and clinical results of balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures.Spine. 2003; 28: 2265-2267
- Minimally invasive treatments of osteoporotic vertebral compression fractures.Spine. 2003; 28: 45-53
- The clinical consequences of vertebral compression fracture.Bone. 1992; 13: S27-S31
- Biomechanical comparison of unipedicular versus bipedicular kyphoplasty.Spine. 2005; 30: 201-205
- Biomechanical efficacy of unipedicular versus bipedicular vertebroplasty for the management of osteoporotic compression fractures.Spine. 1999; 24: 1772-1776
Accepted: September 11, 2009
© 2009 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.