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Updated: May 15, 2025
Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
Published on: September 16, 2022
Modified versus conventional percutaneous kyphoplasty for osteoporotic vertebral compression fracture treatment: a
Yihao Tao1,2, Zhouqi Guo1, Liying Miao1
1Department of Orthopedics, Fifth Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.
Purpose:
This study compares the safety and clinical effectiveness of modified percutaneous kyphoplasty (PKP) approaches (transverse process-pedicle or extrapedicular) with the conventional transpedicular approach for treating osteoporotic vertebral compression fractures.
Methods:
We searched various databases, including PubMed, Cochrane Library, Web of Science, Embase, and Scopus. Safety outcomes included operative time, radiation dose, injected cement volume, and cement leakage rate, while efficacy outcomes were the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Cobb's angle, and vertebral body height. The quality of cohort studies was assessed using the Newcastle-Ottawa Score, and a meta-analysis was conducted using Review Manager 5.4.
Results:
Nine high-quality cohort studies involving 1,187 patients were included. Compared to conventional PKP, the modified approach resulted in significantly shorter operative time (mean differences [MD]: - 11.72, 95% confidence interval [CI]: - 16.56 to - 6.88, p < 0.00001), lower radiation dose (standardized mean differences: - 2.21, 95% CI: - 2.96 to - 1.45, p < 0.00001), reduced injected cement volume (MD: - 0.89, 95% CI: - 1.58 to - 0.21, p = 0.01), and a lower cement leakage rate (MD: 0.58, 95% CI: 0.41-0.80, p = 0.001). However, both groups had no significant differences in VAS score, ODI score, Cobb's angle, or vertebral body height.
Conclusion:
No significant difference in pain relief or functional improvement was observed between modified and conventional PKP. However, modified PKP has a shorter operative time, a lower radiation dose, a lower injected cement volume, and a lower cement leakage rate than conventional PKP. These findings suggest that modified PKP is safer, with similar therapeutic outcomes to conventional PKP.
