Comparison of Percutaneous Kyphoplasty Versus Modified Percutaneous Kyphoplasty for Treatment of Osteoporotic Vertebral Compression Fractures

BACKGROUND: Although percutaneous kyphoplasty (PKP) is performed to restore the vertebral body height and kyphosis in osteoporotic vertebral compression fractures (OVCFs), the regained height may be lost on balloon deflation. This study compares PKP with modified percutaneous kyphoplasty (MPKP) in terms of the clinical outcomes in treating OVCFs. METHODS: Between May 2014 and March 2016, 76 patients with OVCFs were randomly assigned to 2 groups according to the procedure chosen: the PKP group (n = 36) and MPKP group (n = 40). Perioperative parameters, radiologic data, and other clinical parameters were compared between the groups. RESULTS: Of the 76 patients, 68 were followed-up for an average of 16 months. Both groups showed similar degrees of postoperative improvement on the visual analog scale, without any significant intergroup difference. However, the MPKP group showed greater improvement in vertebral body height and recovery of the Cobb angle compared with the PKP group. Additionally, the volume of bone cement and operative time were significantly higher in the MPKP group than in the PKP group, whereas the Oswestry Disability Index at the last follow-up was significantly lower in the MPKP group than in the PKP group. The cement leakage ratio and incidence of recurrent vertebral fractures did not differ significantly between the groups. CONCLUSIONS: MPKP prevents the loss of vertebral height observed with PKP during balloon deflation in addition to providing greater height, Cobb angle recovery, and quality of life compared with PKP in cases of OVCF.