Semin intervent Radiol 2018; 35(04): 309-323
DOI: 10.1055/s-0038-1673639
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Percutaneous Vertebral Augmentation Techniques in Osteoporotic and Traumatic Fractures

Valérie Bousson
1   Service de Radiologie Ostéoarticulaire, Viscérale et Vasculaire, Hôpital Lariboisière, APHP, Université Paris-Diderot, Paris, France
,
Bassam Hamze
1   Service de Radiologie Ostéoarticulaire, Viscérale et Vasculaire, Hôpital Lariboisière, APHP, Université Paris-Diderot, Paris, France
,
Guillaume Odri
2   Service de Chirurgie Orthopédique et Traumatologique, Hôpital Lariboisière, APHP, Université Paris-Diderot, Paris, France
,
Thomas Funck-Brentano
3   Service de Rhumatologie, Hôpital Lariboisière, APHP, Université Paris-Diderot, Paris, France
,
Philippe Orcel
3   Service de Rhumatologie, Hôpital Lariboisière, APHP, Université Paris-Diderot, Paris, France
,
Jean-Denis Laredo
1   Service de Radiologie Ostéoarticulaire, Viscérale et Vasculaire, Hôpital Lariboisière, APHP, Université Paris-Diderot, Paris, France
› Author Affiliations
Further Information

Publication History

Publication Date:
05 November 2018 (online)

Abstract

Percutaneous vertebral augmentation/consolidation techniques are varied. These are vertebroplasty, kyphoplasty, and several methods with percutaneous introduction of an implant (associated or not with cement injection). They are proposed in painful osteoporotic vertebral fractures and traumatic fractures. The objectives are to consolidate the fracture and, if possible, to restore the height of the vertebral body to reduce vertebral and regional kyphosis. Stabilization of the fracture leads to a reduction in pain and thus restores the spinal support function as quickly as possible, which is particularly important in the elderly. The effectiveness of these interventions on fracture pain was challenged once by two randomized trials comparing vertebroplasty to a sham intervention. Since then, many other randomized studies in support of vertebroplasty efficacy have been published. International recommendations reserve vertebroplasty for medical treatment failures on pain, but earlier positioning may be debatable if the objective is to limit kyphotic deformity or even reexpand the vertebral body. Recent data suggest that in osteoporotic fracture, the degree of kyphosis reduction achieved by kyphoplasty and percutaneous implant techniques, compared with vertebroplasty, is not sufficient to justify the additional cost and the use of a somewhat longer and traumatic procedure. In young patients with acute traumatic fractures and a significant kyphotic angle, kyphoplasty and percutaneous implant techniques are preferred to vertebroplasty, as in these cases a deformity reduction has a significant positive impact on the clinical outcome.

 
  • References

  • 1 Fechtenbaum J, Cropet C, Kolta S, Verdoncq B, Orcel P, Roux C. Reporting of vertebral fractures on spine X-rays. Osteoporos Int 2005; 16 (12) 1823-1826
  • 2 Lindsay R, Silverman SL, Cooper C. , et al. Risk of new vertebral fracture in the year following a fracture. JAMA 2001; 285 (03) 320-323
  • 3 Roux C, Fechtenbaum J, Kolta S, Said-Nahal R, Briot K, Benhamou C-L. Prospective assessment of thoracic kyphosis in postmenopausal women with osteoporosis. J Bone Miner Res 2010; 25 (02) 362-368
  • 4 Edidin AA, Ong KL, Lau E, Kurtz SM. Life expectancy following diagnosis of a vertebral compression fracture. Osteoporos Int 2013; 24 (02) 451-458
  • 5 Magerl F, Aebi M, Gertzbein SD, Harms J, Nazarian S. A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 1994; 3 (04) 184-201
  • 6 Vaccaro AR, Lehman Jr RA, Hurlbert RJ. , et al. A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status. Spine 2005; 30 (20) 2325-2333
  • 7 Patel AA, Dailey A, Brodke DS. , et al; Spine Trauma Study Group. Thoracolumbar spine trauma classification: the Thoracolumbar Injury Classification and Severity Score system and case examples. J Neurosurg Spine 2009; 10 (03) 201-206
  • 8 Galibert P, Deramond H, Rosat P, Le Gars D. [Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty]. Neurochirurgie 1987; 33 (02) 166-168
  • 9 Phillips FM, Todd Wetzel F, Lieberman I, Campbell-Hupp M. An in vivo comparison of the potential for extravertebral cement leak after vertebroplasty and kyphoplasty. Spine 2002; 27 (19) 2173-2178 , discussion 2178–2179
  • 10 Cook SD, Salkeld SL, Stanley T, Faciane A, Miller SD. Biomechanical study of pedicle screw fixation in severely osteoporotic bone. Spine J 2004; 4 (04) 402-408
  • 11 Sarzier JS, Evans AJ, Cahill DW. Increased pedicle screw pullout strength with vertebroplasty augmentation in osteoporotic spines. J Neurosurg 2002; 96 (3, Suppl): 309-312
  • 12 Pesenti S, Graillon T, Mansouri N. , et al. [Use of pedicle percutaneous cemented screws in the management of patients with poor bone stock]. Neurochirurgie 2016; 62 (06) 306-311
  • 13 Pesenti S, Blondel B, Peltier E, Adetchessi T, Dufour H, Fuentes S. Percutaneous cement-augmented screws fixation in the fractures of the aging spine: is it the solution?. BioMed Res Int 2014; 2014: 610675
  • 14 Cankaya D, Yilmaz S, Deveci A. , et al. Clinical and radiological outcomes of conservative treatment after stable post-traumatic thoracolumbar fractures in elderly: Is it really best option for all elderly patients?. Ann Med Surg (Lond) 2015; 4 (04) 346-350
  • 15 Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E. FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 2008; 19 (04) 385-397
  • 16 Buchbinder R, Osborne RH, Ebeling PR. , et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 2009; 361 (06) 557-568
  • 17 Kallmes DF, Comstock BA, Heagerty PJ. , et al. A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 2009; 361 (06) 569-579
  • 18 Wilson DJ, Owen S, Corkill RA. Facet joint injections as a means of reducing the need for vertebroplasty in insufficiency fractures of the spine. Eur Radiol 2011; 21 (08) 1772-1778
  • 19 Pishnamaz M, Oikonomidis S, Knobe M, Horst K, Pape H-C, Kobbe P. Open versus percutaneous stabilization of thoracolumbar spine fractures: a short-term functional and radiological follow-up. Acta Chir Orthop Traumatol Cech 2015; 82 (04) 274-281
  • 20 Cimatti M, Forcato S, Polli F, Miscusi M, Frati A, Raco A. Pure percutaneous pedicle screw fixation without arthrodesis of 32 thoraco-lumbar fractures: clinical and radiological outcome with 36-month follow-up. Eur Spine J 2013; 22 (Suppl. 06) S925-S932
  • 21 Cortet B, Cotten A, Boutry N. , et al. Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study. J Rheumatol 1999; 26 (10) 2222-2228
  • 22 Cyteval C, Sarrabère MP, Roux JO. , et al. Acute osteoporotic vertebral collapse: open study on percutaneous injection of acrylic surgical cement in 20 patients. AJR Am J Roentgenol 1999; 173 (06) 1685-1690
  • 23 Diamond TH, Bryant C, Browne L, Clark WA. Clinical outcomes after acute osteoporotic vertebral fractures: a 2-year non-randomised trial comparing percutaneous vertebroplasty with conservative therapy. Med J Aust 2006; 184 (03) 113-117
  • 24 Heini PF, Wälchli B, Berlemann U. Percutaneous transpedicular vertebroplasty with PMMA: operative technique and early results. A prospective study for the treatment of osteoporotic compression fractures. Eur Spine J 2000; 9 (05) 445-450
  • 25 Zoarski GH, Snow P, Olan WJ. , et al. Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. J Vasc Interv Radiol 2002; 13 (2, Pt 1): 139-148
  • 26 Coumans JV, Reinhardt MK, Lieberman IH. Kyphoplasty for vertebral compression fractures: 1-year clinical outcomes from a prospective study. J Neurosurg 2003; 99 (1, Suppl): 44-50
  • 27 Lieberman IH, Dudeney S, Reinhardt MK, Bell G. Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine 2001; 26 (14) 1631-1638
  • 28 Theodorou DJ, Theodorou SJ, Duncan TD, Garfin SR, Wong WH. Percutaneous balloon kyphoplasty for the correction of spinal deformity in painful vertebral body compression fractures. Clin Imaging 2002; 26 (01) 1-5
  • 29 Taylor RS, Fritzell P, Taylor RJ. Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis. Eur Spine J 2007; 16 (08) 1085-1100
  • 30 Pateder DB, Khanna AJ, Lieberman IH. Vertebroplasty and kyphoplasty for the management of osteoporotic vertebral compression fractures. Orthop Clin North Am 2007; 38 (03) 409-418 , abstract vii
  • 31 Eck JC, Nachtigall D, Humphreys SC, Hodges SD. Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature. Spine J 2008; 8 (03) 488-497
  • 32 Denoix E, Viry F, Ostertag A. , et al. What are the predictors of clinical success after percutaneous vertebroplasty for osteoporotic vertebral fractures?. Eur Radiol 2018; 28 (07) 2735-2742
  • 33 Blasco J, Martinez-Ferrer A, Macho J. , et al. Effect of vertebroplasty on pain relief, quality of life, and the incidence of new vertebral fractures: a 12-month randomized follow-up, controlled trial. J Bone Miner Res 2012; 27 (05) 1159-1166
  • 34 Farrokhi MR, Alibai E, Maghami Z. Randomized controlled trial of percutaneous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures. J Neurosurg Spine 2011; 14 (05) 561-569
  • 35 Klazen CA, Lohle PN, de Vries J. , et al. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet 2010; 376 (9746): 1085-1092
  • 36 Rousing R, Hansen KL, Andersen MO, Jespersen SM, Thomsen K, Lauritsen JM. Twelve-months follow-up in forty-nine patients with acute/semiacute osteoporotic vertebral fractures treated conservatively or with percutaneous vertebroplasty: a clinical randomized study. Spine 2010; 35 (05) 478-482
  • 37 Voormolen MH, Mali WP, Lohle PN. , et al. Percutaneous vertebroplasty compared with optimal pain medication treatment: short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures. The VERTOS study. AJNR Am J Neuroradiol 2007; 28 (03) 555-560
  • 38 Yang E-Z, Xu J-G, Huang G-Z. , et al. Percutaneous vertebroplasty versus conservative treatment in aged patients with acute osteoporotic vertebral compression fractures: a prospective randomized controlled clinical study. Spine 2016; 41 (08) 653-660
  • 39 Wardlaw D, Cummings SR, Van Meirhaeghe J. , et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet 2009; 373 (9668): 1016-1024
  • 40 Clark W, Bird P, Gonski P. , et al. Safety and efficacy of vertebroplasty for acute painful osteoporotic fractures (VAPOUR): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet 2016; 388 (10052): 1408-1416
  • 41 Dohm M, Black CM, Dacre A, Tillman JB, Fueredi G. ; KAVIAR Investigators. A randomized trial comparing balloon kyphoplasty and vertebroplasty for vertebral compression fractures due to osteoporosis. AJNR Am J Neuroradiol 2014; 35 (12) 2227-2236
  • 42 Evans AJ, Kip KE, Brinjikji W. , et al. Randomized controlled trial of vertebroplasty versus kyphoplasty in the treatment of vertebral compression fractures. J Neurointerv Surg 2016; 8 (07) 756-763
  • 43 Liu JT, Liao WJ, Tan WC. , et al. Balloon kyphoplasty versus vertebroplasty for treatment of osteoporotic vertebral compression fracture: a prospective, comparative, and randomized clinical study. Osteoporos Int 2010; 21 (02) 359-364
  • 44 Barr JD. Randomized controlled trial of vertebroplasty versus kyphoplasty in the treatment of vertebral compression fractures. J Neurointerv Surg 2016; 8 (07) 765-766
  • 45 Carlier RY, Gordji H, Mompoint DM, Vernhet N, Feydy A, Vallée C. Osteoporotic vertebral collapse: percutaneous vertebroplasty and local kyphosis correction. Radiology 2004; 233 (03) 891-898
  • 46 Ledlie JT, Renfro MB. Kyphoplasty treatment of vertebral fractures: 2-year outcomes show sustained benefits. Spine 2006; 31 (01) 57-64
  • 47 Bossard P, Tran O, Vicaut E, Laredo JD. Vertebroplasty versus balloon kyphoplasty in osteoporotic fractures: results from a prospective randomized clinical trial. Personal communication
  • 48 Krüger A, Baroud G, Noriega D. , et al. Height restoration and maintenance after treating unstable osteoporotic vertebral compression fractures by cement augmentation is dependent on the cement volume used. Clin Biomech (Bristol, Avon) 2013; 28 (07) 725-730
  • 49 Krüger A, Oberkircher L, Figiel J. , et al. Height restoration of osteoporotic vertebral compression fractures using different intravertebral reduction devices: a cadaveric study. Spine J 2015; 15 (05) 1092-1098
  • 50 Lin JH, Wang SH, Lin EY, Chiang YH. Better height restoration, greater kyphosis correction, and fewer refractures of cemented vertebrae by using an intravertebral reduction device: a 1-year follow-up study. World Neurosurg 2016; 90: 391-396
  • 51 Fribourg D, Tang C, Sra P, Delamarter R, Bae H. Incidence of subsequent vertebral fracture after kyphoplasty. Spine 2004; 29 (20) 2270-2276 , discussion 2277
  • 52 Grafe IA, Da Fonseca K, Hillmeier J. , et al. Reduction of pain and fracture incidence after kyphoplasty: 1-year outcomes of a prospective controlled trial of patients with primary osteoporosis. Osteoporos Int 2005; 16 (12) 2005-2012
  • 53 Mudano AS, Bian J, Cope JU. , et al. Vertebroplasty and kyphoplasty are associated with an increased risk of secondary vertebral compression fractures: a population-based cohort study. Osteoporos Int 2009; 20 (05) 819-826
  • 54 Uppin AA, Hirsch JA, Centenera LV, Pfiefer BA, Pazianos AG, Choi IS. Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. Radiology 2003; 226 (01) 119-124
  • 55 Grados F, Depriester C, Cayrolle G, Hardy N, Deramond H, Fardellone P. Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheumatology (Oxford) 2000; 39 (12) 1410-1414
  • 56 Frankel BM, Monroe T, Wang C. Percutaneous vertebral augmentation: an elevation in adjacent-level fracture risk in kyphoplasty as compared with vertebroplasty. Spine J 2007; 7 (05) 575-582
  • 57 Briot K, Cortet B, Thomas T. , et al. 2012 update of French guidelines for the pharmacological treatment of postmenopausal osteoporosis. Joint Bone Spine 2012; 79 (03) 304-313
  • 58 Knavel EM, Thielen KR, Kallmes DF. Vertebroplasty for the treatment of traumatic nonosteoporotic compression fractures. AJNR Am J Neuroradiol 2009; 30 (02) 323-327
  • 59 Teyssédou S, Saget M, Gayet LE, Pries P, Brèque C, Vendeuvre T. Radiologic study of disc behavior following compression fracture of the thoracolumbar hinge managed by kyphoplasty: a 52-case series. Orthop Traumatol Surg Res 2016; 102 (01) 61-65
  • 60 Koller H, Acosta F, Hempfing A. , et al. Long-term investigation of nonsurgical treatment for thoracolumbar and lumbar burst fractures: an outcome analysis in sight of spinopelvic balance. Eur Spine J 2008; 17 (08) 1073-1095
  • 61 Mayer M, Ortmaier R, Koller H. , et al. Impact of sagittal balance on clinical outcomes in surgically treated T12 and L1 burst fractures: analysis of long-term outcomes after posterior-only and combined posteroanterior treatment. BioMed Res Int 2017; 2017: 1568258
  • 62 Glassman SD, Bridwell K, Dimar JR, Horton W, Berven S, Schwab F. The impact of positive sagittal balance in adult spinal deformity. Spine 2005; 30 (18) 2024-2029
  • 63 Mac-Thiong JM, Transfeldt EE, Mehbod AA. , et al. Can c7 plumbline and gravity line predict health related quality of life in adult scoliosis?. Spine 2009; 34 (15) E519-E527
  • 64 Laredo JD, Hamze B. Complications of percutaneous vertebroplasty and their prevention. Skeletal Radiol 2004; 33 (09) 493-505
  • 65 Venmans A, Klazen CA, Lohle PN. , et al. Percutaneous vertebroplasty and pulmonary cement embolism: results from VERTOS II. AJNR Am J Neuroradiol 2010; 31 (08) 1451-1453
  • 66 Hulme PA, Krebs J, Ferguson SJ, Berlemann U. Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine 2006; 31 (17) 1983-2001
  • 67 Kasper DM. Kyphoplasty. Semin Intervent Radiol 2010; 27 (02) 172-184
  • 68 Jay B, Ahn SH. Vertebroplasty. Semin Intervent Radiol 2013; 30 (03) 297-306
  • 69 Prince EA, Ahn SH. Interventional management of vertebral body metastases. Semin Intervent Radiol 2013; 30 (03) 278-281
  • 70 Wang DT, Dubois M, Tutton SM. Complications in musculoskeletal intervention: important considerations. Semin Intervent Radiol 2015; 32 (02) 163-173
  • 71 Lea W, Tutton S. Decision making: osteoplasty, ablation, or combined therapy for spinal metastases. Semin Intervent Radiol 2017; 34 (02) 121-131