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No Benefit of Vertebral Body Stenting Over Kyphoplasty

No Benefit of Vertebral Body Stenting Over Kyphoplasty

Higher pressures during balloon inflation and more material-related complications with stenting

WEDNESDAY, May 15 (HealthDay News) -- Among patients with painful osteoporotic vertebral fractures, there is no benefit to vertebral body stenting over balloon kyphoplasty, according to a study published in the April 3 issue of The Journal of Bone & Joint Surgery.

Clément M.L. Werner, M.D., from the University of Zurich, and colleagues conducted a randomized controlled trial in which patients with 100 fresh osteoporotic vertebral compression fractures were treated with either balloon kyphoplasty or vertebral body stenting.

The researchers found that in balloon kyphoplasty the mean reduction (and standard deviation) of kyphosis (the kyphotic correction angle) was 4.5 ± 3.6 degrees; the mean reduction was 4.7 ± 4.2 degrees after vertebral body stenting (P = 0.972). During vertebral body stenting the mean pressure was 24 ± 5 bar (348 ± 72 pounds per square inch [psi]); the mean pressure was 16 ± 6 bar (233 ± 81 psi) during balloon kyphoplasty (P = 0.014). Radiation exposure time did not significantly differ between the groups. None of the patients underwent revision surgery. Cement leakage (25 of 100 vertebral levels) did not significantly differ between the groups. In the balloon kyphoplasty group, intraoperative material-related complications were seen at one of the fifty vertebral levels; these complications were seen at nine of the fifty levels in the vertebral body stenting group.

"No beneficial effect of vertebral body stenting over balloon kyphoplasty was found among patients with painful osteoporotic vertebral fractures with regard to kyphotic correction, cement leakage, radiation exposure time, or neurologic sequelae," the authors write.

Abstract (http://jbjs.org/article.aspx?articleid=1668919 )Full Text (subscription or payment may be required) (http://jbjs.org/article.aspx?articleid=1668919 )