A recent meta-analysis of 124 studies comparing the complication rates from vertebroplasty and kyphoplasty, has revealed that kyphoplasty appears to be associated with lower procedure related complications than vertebroplasty. The findings were presented at the recent North American Spine Society (NASS) meeting held in Austin, Texas, by Dr Michael Lee, Rush University Medical Center, Chicago, IL, US. According to the results, vertebroplasty and balloon kyphoplasty provide symptomatic relief of vertebral compression fractures (VCF) refractory to medical therapy. Although rare, complications that may arise can be potentially devastating, specifically, extravasation of cement out of the vertebral body is a known complication. He explained that complications after vertebroplasty and kyphoplasty have been reported in small case-report series, and events that are considered complications may vary considerably from study to study. In this study, entitled, ’A comparison of complications from vertebroplasty and kyphoplasty: A meta-analysis of 124 studies’, complications from studies conducted from 1994 to 2006 were recorded, and categorised into three groups: procedure related, medical, and the onset of acute new vertebral fractures. Lee explained that of the 124 studies that identified kyphoplasty and vertebroplasty complications, 37 addressed kyphoplasty and 89 addressed vertebroplasty (two reports addressed complications of both). It was reported that in the kyphoplasty group, 1.6% of patients (24/1491) experienced a medical complication, whereas, in the vertebroplasty group, 0.4% (22/5629) experienced a medical complication. In terms of procedure-related complications, in the kyphoplasty group, 0.6% (9/1491) experienced such complications, versus 3.8% (215/5629) in the vertebroplasty group. Lee added that the ratio of new fractures that occurred per levels treated was 13% (158/1192) in the kyphoplasty group and was 21% (830/3912) in the vertebroplasty group. Fourteen percent (184/1297) of patients in the kyphoplasty group and 75% (3078/4096) of the vertebroplasty group experienced a cement leak. In his concluding remarks, Lee explained that based on the current literature, the incidence of procedure-related complications appears to be lower for kyphoplasty than vertebroplasty, and kyphoplasty also appears to be associated with a lower new fracture rate than vertebroplasty.
