Journal of Pain Research (Oct 2020)
Comparison Between Hyperextension and Neutral Positions for Vertebroplasty and Kyphoplasty: Which is Best for Osteoporotic Vertebral Compression Fractures?
Abstract
Yan Ding,1,* Shengjie Dong,1,* Jingjie Wang,1 Jinpeng Cui,2 Zhilin Cao,1 Shiqiao Lv1 1Department of Orthopaedics, Yantaishan Hospital, Yantai 264000, People’s Republic of China; 2Clinical Laboratory, Yantaishan Hospital, Yantai 264000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shiqiao LvDepartment of Orthopaedics, Yantaishan Hospital, No. 91 Jiefang Road, Yantai 264000, People’s Republic of ChinaTel +86-13001612636Email [email protected]: This study aimed to compare the demographic features (including total cost), surgical effects, radiographic parameters, and complications of kyphoplasty (KP) and vertebroplasty (VP) in the hyperextension (HP) and neutral positions (NP) and to assess their efficacy and cost-effectiveness for treating single-level osteoporotic vertebral compression fractures (OVCF).Patients and Methods: This was a retrospective analysis of 245 consecutive patients who underwent KP or VP from February 2018 to February 2019 with observation on postoperative day 2 and at the one-year follow-up. The first 122 patients (86 KP and 36 VP cases) were treated in the neutral position, and the remaining 123 in the hyperextension position (90 VP and 33 KP cases). Back pain and impact on daily life were evaluated. Cobb’s angle and the ratio of the anterior (AR) and middle vertebral (MR) bodies were the main radiographic parameters. The chi-square test, one-way analysis of variance (ANOVA), repeated measurement ANOVA, and post hoc tests (Bonferroni adjustments) were used for statistical analysis.Results: There were no significant differences in the demographic features, operation time, or rate of re-fracture at the one-year follow-up among the groups. The rate of cement leakage was significantly lower in the HPVP group than in the NPKP group. The total cost was significantly lower in the VP groups than in the KP groups. At the one-year follow-up, back pain was significantly lower in the HPVP group than in the NPKP group. The Oswestry Disability Index, Cobb’s angle, AR, and MR in the HPVP group were similar to those in the NPKP and HPKP groups, but better than those in the NPVP group.Conclusion: HPVP can achieve better pain relief, and similar disability scores, Cobb’s angle, AR and MR recovery, with a lower total cost, compared with NPKP. HPVP is the most economically efficacious treatment for OVCF.Keywords: cement leakage, Cobb’s angle, kyphosis, surgical outcome, vertebral height
