Kyphoplasty vs Vertebroplasty?

Kyphoplasty illustration
Kyphoplasty illustration. BSIP/UIG/Collection:Universal Images Group/Getty Images

Kyphoplasty and a Vertebroplasty:  Which works better and how do they compare to non-surgical type treatments?

Kyphoplasty and vertebroplasty are two related minimally invasive spine surgeries used to treat spinal compression fractures.  Most of the time the spinal compression fractures addressed with these procedures are due to osteoporosis.

Both surgeries involve the injection of cement into the bone, and both aim to reduce or eliminate pain and to stabilize the vertebra(e).

Vertebroplasty

In a vertebroplasty, bone cement is injected into the broken areas in order to stabilize the spine.  There's no attempt is made to restore the former height of the bone with this surgery.

Kyphoplasty

A kyphoplasty is similar to a vertebroplasty in that cement is injected into the spinal bone, but this time, a balloon is aslo inserted.  With the use of fluoroscopy,  the balloon is gently inflated to restore  the height and shape of the fractured bone. The balloon is then removed and the bone cement injected. The cement dries within 5 minutes, while you're still on the operating table.

Vertebroplasty vs Kyphoplasty:  Which Heals Spinal Compression Fractures Better?

Studies show that kyphoplasty and vertebroplasty yield better results for patients than do conservative care.  Conservative care may consist of physical therapy and medication. 

For example, a study by Wardlaw, Cummings and van Meirhaeghe entitled, "Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture: a randomized controlled trial," published in the March 2009 issue of The Lancet, found that balloon kyphoplasty reduces pain and disability much faster than non-surgical interventions.

  The researchers also found  that their patients’ quality of life improved faster when balloon kyphoplasty was done (as compared to non-surgical treatments.) 

But what about how well vertebroplasty and kyphoplasty compare as a treatment for compression fractures?

Brinjikji, et. al. in their study, “Outcomes of vertebroplasty compared with kyphoplasty: a systematic review and meta-analysis,” which was published in the Journal of Neurointerventional Surgery in May of 2015, found no significant long term or short term differences between the two – whether it was pain relief that was being evaluated or disability.

The study focused on a general population, which means if there’s a particular subgroup for which either procedure may be especially suited as a compression fracture treatment, it is not known.  The authors say that more studies are necessary so that doctors can better identify who might get the most out of vertebroplasty and/or kyphoplasty.

Sources:

Gu, C., Brinjikji, W., Evans, A., Murad, M., Kallmes, D. Outcomes of vertebroplasty compared with kyphoplasty: a systematic review and meta-analysis. J NeuroIntervent Surg. May 2015. Accessed Feb 2016.

Vertebroplasty. NIH. U.S. National Library of Medicine website. Last Update: Oct 2013. Accessed Feb 2016.

Wardlaw D, Cummings S, Van Meirhaeghe J, et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture: a randomized controlled trial. The Lancet, March 2009. Accessed: Feb 2016.

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