medigraphic.com
ISSN 2992-7749 (Electronic)
ISSN 2992-7897 (Print)
Órgano Oficial de difusión científica de la Asociación Mexicana de Cirujanos de Columna A. C.

2025, Number 4

<< Back Next >>

Cir Columna 2025; 3 (4)

Long-term ambispective follow-up of kyphoplasty plus pulsed radiofrequency as a standard treatment for vertebral compression fractures

Chávez LJA, Hernández BJL, Chávez CRD

Language: Spanish
References: 37
Page: 274-284
PDF size: 951.70 Kb.


ABSTRACT

Objective: to evaluate the efficacy and safety of kyphoplasty combined with pulsed radiofrequency (PRF) applied to facet joints as a standard treatment for vertebral compression fractures. Material and methods: multicenter, ambispective study with a retrospective phase (2014-2020) and a prospective phase (2021-2024), including 400 patients aged ≥ 50 years (67% women). Data collected included demographics, fractured levels, visual analog scale (VAS) for pain, Oswestry Disability Index (ODI), comorbidities, and complications. The procedure consisted of standardized percutaneous kyphoplasty followed by PRF. Variables were analyzed preoperatively, on postoperative day 1, and at 1, 3, and 6 months, then annually for up to 10 years. Results: mean VAS pain scores decreased from 9.2 ± 0.7 preoperatively to 0.78 ± 0.68 on the first postoperative day, an absolute reduction of ~ 8.4 points (≈ 91% less pain, p < 0.001, paired t-test). The baseline ODI averaged 88.8% ± 6.5%; after the intervention, it dropped to 25% within 24 hours, with continued long-term improvement in functionality. Complication rates were low: adjacent fracture 8%, cement leakage 3%, and infection < 0%. No significant differences in outcomes were found based on diabetes, hypertension, obesity, or osteoporosis. Conclusions: kyphoplasty combined with PRF provides immediate and sustained pain relief, significant functional improvement, and a favorable safety profile, establishing it as a standard therapeutic option for vertebral compression fractures.


REFERENCES

  1. Zhang Y, Wang Y, Li Y, Zhang Y, Wang Y, Zhang Y, et al. Comparison of the efficacy and safety of percutaneous vertebroplasty and kyphoplasty for osteoporotic vertebral compression fractures: A systematic review and meta-analysis. Medicine (Baltimore). 2025; 104: e33097. doi: 10.1097/MD.0000000000033097

  2. Gozel T, Ortiz AO. Vertebral augmentation for osteoporotic vertebral compression fractures: what is the current evidence pro and con? Radiol Clin North Am. 2024; 62: 979-991. doi: 10.1016/j.rcl.2024.03.004

  3. Sun Y, Li X, Ma S, Chong H, Cai T, Li K, et al. Comparison of the efficacy and safety of unilateral and bilateral approach kyphoplasty in the treatment of osteoporotic vertebral compression fractures: a meta-analysis. Jt Dis Relat Surg. 2024; 35: 491-503. doi: 10.52312/jdrs.2024.1701

  4. Krishnan S, Brovman EY, Jones MR, Manzi JE, Kim JS, Rao N, et al. Racial and socioeconomic disparities in kyphoplasty among the Medicare population. Pain Pract. 2024; 24: 76-81. doi: 10.1111/papr.13286

  5. Garfin SR, Yuan HA, Reiley MA. New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine (Phila Pa 1976). 2001; 26: 1511-1515. doi: 10.1097/00007632-200108010-00020

  6. Liu JT, Li CS, Chang CS, Liao WJ. Long-term follow-up study of osteoporotic vertebral compression fracture treated using balloon kyphoplasty and vertebroplasty. J Neurosurg Spine. 2015; 23: 94-98. doi: 10.3171/2014.11.SPINE14579

  7. Wardlaw D, Van Meirhaeghe J, Ranstam J, Bastian L, Boonen S. Balloon kyphoplasty in patients with osteoporotic vertebral compression fractures. Expert Rev Med Devices. 2012; 9: 423-436. doi: 10.1586/erd.12.27

  8. Chang X, Lv YF, Chen B, Li HY, Han XB, Yang K, et al. Vertebroplasty versus kyphoplasty in osteoporotic vertebral compression fracture: a metaanalysis of prospective comparative studies. Int Orthop. 2015; 39: 491-500. doi: 10.1007/s00264-014-2525-5

  9. Teraguchi M, Nakagawa Y, Nakatani T, Minetama M, Enyo Y, Maeda T, et al. Effectiveness of ultra-early balloon kyphoplasty at one year after osteoporotic vertebral fracture. J Orthop Sci. 2024: S0949-2658(24)00261-6. doi: 10.1016/j.jos.2024.11.005

  10. Kapetanakis S, Chaniotakis C, Zavridis P, Kopsidas P, Apostolakis S, Gkantsinikoudis N. Vertebroplasty and kyphoplasty in the management of osteoporotic vertebral compression fractures in elderly individuals: evaluation of the health-related quality of life. Eur J Transl Myol. 2024; 34: 12274. doi: 10.4081/ejtm.2024.12274

  11. Li C, Ji H, Cui D, Zhuang S, Zhang C. Association between sarcopenia on residual back pain after percutaneous kyphoplasty for osteoporotic vertebral compression fractures. J Orthop Surg Res. 2025; 20: 550. doi: 10.1186/s13018-025-05902-0

  12. Seah SJS, Yeo MHX, Tan JH, Hey HWD. Early cement augmentation may be a good treatment option for pain relief for osteoporotic compression fractures: a systematic review and meta-analysis. Eur Spine J. 2023; 32: 1751-1762. doi: 10.1007/s00586-023-07658-9

  13. Hirsch JA, Gilligan C, Chandra RV, Brook A, Gasquet NC, Ricker CN, et al. Real-world rates and risk factors for subsequent treatment with vertebroplasty or balloon kyphoplasty after initial vertebral augmentation: a retrospective cohort study. Osteoporos Int. 2025; 36: 129-140. doi: 10.1007/s00198-024-07294-z

  14. Grafe IA, Da Fonseca K, Hillmeier J, Meeder PJ, Libicher M, Noldge G, et al. Reduction of pain and fracture incidence after kyphoplasty: 1-year outcomes of a prospective controlled trial of patients with primary osteoporosis. Osteoporos Int. 2005; 16: 2005-2012. doi: 10.1007/s00198-005-1982-5

  15. Li Y, Yue J, Huang M, Lin J, Huang C, Chen J, et al. Risk factors for postoperative residual back pain after percutaneous kyphoplasty for osteoporotic vertebral compression fractures. Eur Spine J. 2020; 29: 2568-2575. doi: 10.1007/s00586-020-06493-6

  16. McCullough BJ, Comstock BA, Deyo RA, Kreuter W, Jarvik JG. Major medical outcomes with spinal augmentation vs conservative therapy. JAMA Intern Med. 2013; 173: 1514-1521. doi: 10.1001/jamainternmed.2013.832

  17. Benedict C, Chopra AA, Pitcher M, Jeansonne N, Fox E. Rate of osteoporosis evaluation and treatment following kyphoplasty in patients with vertebral compression fractures: a retrospective study and review of the literature. Geriatr Orthop Surg Rehabil. 2025; 16: 21514593251332463. doi: 10.1177/21514593251332463

  18. Kushchayev SV, Wiener PC, Teytelboym OM, Arrington JA, Khan M, Preul MC. Percutaneous vertebroplasty: a history of procedure, technology, culture, specialty, and economics. Neuroimaging Clin N Am. 2019; 29: 481-494. doi: 10.1016/j.nic.2019.07.011

  19. Tombeng MA, Lauren C, Mahadewa TG. Unilateral percutaneous balloon kyphoplasty for thoracic osteoporotic vertebral compression fractures: a case report and literature review. Surg Neurol Int. 2024; 15: 311. doi: 10.25259/SNI_526_2024

  20. McCormick ZL. The growth of radiofrequency denervation for pain indications. Pain Med. 2021; 22: S1. doi: 10.1093/pm/pnab164

  21. Bai M, Wang H, Li A, Zhang T. Effect of percutaneous kyphoplasty combined with percutaneous microwave ablation on pain and clinical outcome in patients with spinal metastases. Eur Spine J. 2025; 34: 657-664. doi: 10.1007/s00586-024-08558-2

  22. Stolzenberg D, Ahn JJ, Kurd M. Lumbar radiofrequency ablation: procedural technique. Clin Spine Surg. 2020; 33: 20-23. doi: 10.1097/BSD.0000000000000780

  23. Golovac S. Radiofrequency neurolysis. Neuroimaging Clin N Am. 2010; 20: 203-214. doi: 10.1016/j.nic.2010.02.007

  24. Chen X, Wang Y, Sheng B, Jiang H. Application of comfortable therapy in percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures. Asian J Surg. 2024; 47: 4501-4502. doi: 10.1016/j.asjsur.2024.07.222

  25. Mehta R, Koneru M, Badger C, Santucci J, Al-Atrache Z, Clay CM, et al. Minimally invasive treatment with radiofrequency ablation and kyphoplasty for avascular necrosis of the spine in sickle cell disease: illustrative case. J Neurosurg Case Lessons. 2024; 8: CASE24343. doi: 10.3171/CASE24343

  26. Park S, Jang JN, Park JH, Song Y, Sooil C, Kim YU, et al. Comparing the effectiveness of pulsed radiofrequency treatment to lumbar dorsal root ganglion according to application times in patients with lumbar radicular pain: protocol for a randomised controlled trial. BMJ Open. 2024; 14: e077847. doi: 10.1136/bmjopen-2023-077847

  27. Zhao H, Ren K, Dong X, Liao B. The clinical efficacy of percutaneous vertebroplasty combined with postural reduction versus kyphoplasty: a systematic review and meta-analysis. J Back Musculoskelet Rehabil. 2025: 10538127241296690. doi: 10.1177/10538127241296690

  28. Than CA, Adra M, Curtis TJ, Shi A, Kim GE, Nakanishi H, et al. The effect of exercise post vertebral augmentation in osteoporotic patients: a systematic review and meta-analysis. J Orthop Res. 2023; 41: 2703-2712. doi: 10.1002/jor.25631

  29. Zhao G, Liu X, Li F. Balloon kyphoplasty versus percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures (OVCFs). Osteoporos Int. 2016; 27: 2823-2834. doi: 10.1007/s00198-016-361

  30. Zhao DH, Chen K, Zhu J, Yang X, Dong F, Wang WB. Postoperative functional evaluation of percutaneous vertebroplasty compared with percutaneous kyphoplasty for vertebral compression fractures. Am J Ther. 2016; 23: e1381-e1390. doi: 10.1097/MJT.0000000000000223

  31. Shen S, You X, Ren Y, Ye S. Adjacent vertebral refracture prediction model based on imaging data after vertebroplasty for osteoporotic vertebral compression fracture. World Neurosurg. 2024; 190: e548-e553. doi: 10.1016/j.wneu.2024.07.169

  32. Zhang A, Lin Y, Kong M, Chen J, Gao W, Fan J, et al. A nomogram for predicting the risk of new vertebral compression fracture after percutaneous kyphoplasty. Eur J Med Res. 2023; 28: 280. doi: 10.1186/s40001-023-01235-y

  33. Sheen S, Hasan P, Sun X, Wang J, Tatsui C, Nouri K, et al. Retrospective analysis of cement extravasation rates in vertebroplasty, kyphoplasty, and bone tumor radiofrequency ablation. J Clin Med. 2025; 14: 2908. doi: 10.3390/jcm14092908

  34. Dai X, Chen L, Pan D, Zhao H, Ma L. Bone cement embolism causing right ventricle perforation. BMC Cardiovasc Disord. 2025; 25: 101. doi: 10.1186/s12872-025-04551-9

  35. Cho SJ, Magale H, Dimitrov K. Cemented in place: kyphoplasty-associated pulmonary cement embolism: a case report. J Med Case Rep. 2024; 18: 407. doi: 10.1186/s13256-024-04656-3

  36. Tang J, Liu J, Gu Z, Zhang Y, Yang H, Li Z. The temporal and spatial relationship between percutaneous vertebral augmentation and new symptomatic fractures. Diagn Interv Radiol. 2024; 30: 262-269. doi: 10.4274/dir.2023.221424

  37. Matsumoto K, Hoshino M, Omori K, Igarashi H, Matsuzaki H, Sawada H, et al. The relationship between global sagittal balance and the incidence of early adjacent vertebral fractures following balloon kyphoplasty. World Neurosurg. 2023; 175: e818-e822. doi: 10.1016/j.wneu.2023.04.027




2020     |     www.medigraphic.com