ABSTRACT
The advent of the use of kyphoplasty in 1998 was the result of the expected evolution
of materials and methods related to the successful introduction of vertebroplasty
as a valid treatment of painful vertebral compression fractures. Kyphoplasty introduced
a method of creating bilateral bone voids and in many cases elevation (reduction)
of depressed end plates with variable degrees of height restoration. This was achieved
by using bilateral balloon bone tamps capable of pressures significantly higher than
conventional angioplasty balloons. This allows creation of bilateral bone voids, resulting
in the ability to apply a much thicker cement mixture. This is felt to be the reason
for fewer cement-related complications compared with vertebroplasty including extravasation
and embolization. Although the procedural cost presently is higher for kyphoplasty,
this is expected to decrease as patents expire and industry competition increases.
Kyphoplasty indications include all those of vertebroplasty plus additional ones either
contraindicated or not recommended for treatment with vertebroplasty. Kyphoplasty
achieves the same degree of pain relief as vertebroplasty but may offer additional
benefits of fewer complications, more indications, better biopsy specimens, and potential
for height restoration of compression fractures of the spine. Further studies regarding
potential benefits are warranted to assess any added value of kyphoplasty compared
with vertebroplasty.
KEYWORDS
Kyphoplasty - vertebral compression fractures - vertebroplasty - pathological fractures
- osteoporosis - vertebral augmentation
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David M KasperM.D. F.R.C.P.C.
Division of Interventional Radiology, Mayo Hospital
5777 East Mayo Boulevard, Phoenix, AZ 85054
Email: kasper.david8@mayo.edu