Clinical Relevance of Cement Leakage after Radiofrequency Kyphoplasty vs. Balloon Kyphoplasty: A Prospective Randomised Study
| Autor: | Hans-Joachim Riesner, K. Kiupel, H.-G. Palm, Benedikt Friemert, Patricia Lang, Fabian Stuby |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Balloon Inferior vena cava law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Humans Medicine Kyphoplasty Orthopedics and Sports Medicine Clinical significance Prospective Studies Prospective cohort study Aged 030222 orthopedics business.industry Significant difference Bone Cements Surgery Treatment Outcome medicine.vein Catheter Ablation Spinal Fractures Female Complication business 030217 neurology & neurosurgery Extravasation of Diagnostic and Therapeutic Materials Cement leakage |
| Zdroj: | Zeitschrift für Orthopädie und Unfallchirurgie. 154:370-376 |
| ISSN: | 1864-6743 1864-6697 |
| Popis: | Background: Cement leakage is regarded as a typical complication of cement-based augmentation of vertebral fractures. The gold standard is balloon kyphoplasty (BK). Recent methods, such as radiofrequency kyphoplasty (RFK), must be compared with BK in terms of therapeutic success and complication rates. It is unclear whether the cement leakage rate in RFK is lower than with BK and whether this has any clinical relevance. Therefore, the aim of our prospective clinical study was to compare RFK with BK with respect to cement leakage rates and associated clinical complications. Patients and Methods: After prospective randomisation, 100 patients (76 women and 24 men with an average age of 78.5 years) or 162 vertebral bodies were treated by BK (n = 79) or RFK (n = 83). We evaluated the parameters “localisation of cement leakage” (epidural, intradiscal, extracorporal, intravascular) and “clinical relevance”. Results: More cement is used in BK (5.2 ml) than in RFK (4.0 ml, p = 0.001). Cement leakage was found in 48/79 patients (60.8 %) with BK and 53/83 patients (63.9 %) with RFK (p = 0.420). Even subanalysis by location showed no significant difference between the two methods. Despite the high leakage rates, we experienced only two cases (1× BK, 1× RFK) with intravascular leakage in the inferior vena cava, with interventional endovascular salvage. Conclusion: The two examined kyphoplasty methods (BK vs. RFK) have the same high rates of cement leakage, but are rarely associated with clinically manifest complications. Clinically relevant differences between the two compared kyphoplasty methods could not be found. |
| Databáze: | OpenAIRE |
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