Single-balloon versus double-balloon bipedicular kyphoplasty for osteoporotic vertebral compression fractures

Twenty-eight patients with osteoporotic vertebral compression fractures (OVCF) were treated with single-balloon bipedicular kyphoplasty (Group A), and 40 patients were treated with double-balloon bipedicular kyphoplasty (Group B). Visual Analogue Scale (VAS) score, vertebral height, and kyphotic angle (KA) were evaluated pre-operatively, post-operatively (3 days after surgery) and at final follow-up. Operative time, X-ray exposure frequency and costs were recorded. The mean operative time and X-ray exposure frequency in Group A were greater than in Group B (p<0.05). Significant improvement of the VAS score was noted in each group, and remained unchanged at final follow-up. Mean increases of anterior and middle height of the fractured vertebral body were 5.14mm and 4.14mm in Group A, respectively, and 6.22mm and 5.06mm in Group B, respectively, and the differences between the groups were statistically significant (p<0.05). Mean reduction of KA was 6.9° in Group A and 8.8° in Group B, which was statistically significant (p<0.05). No statistically significant difference was observed in terms of cement leakage between groups. The mean cost of Group A (US$4202) was significantly less than that of Group B (US$6220) (p<0.001). Single-balloon bipedicular kyphoplasty is a safe and cost-effective surgical method for the treatment of OVCF. It can achieve pain relief comparable with double-balloon bipedicular kyphoplasty. However, double-balloon bipedicular kyphoplasty is more efficacious in terms of the restoration of vertebral height and reduction of KA, and the operative time and X-ray exposure frequency are lower.