Percutane vertebroplastiek versus kyfoplastiek. (Dutch/Flemish)

Vertebral compression fractures are a significant cause of morbidity and mortality in the elderly population. Osteoporosis is the main cause of these fractures. There are several treatment options for a vertebral compression fracture. Treatment usually consists of bed rest, analgetics, bracing, physical therapy and anti-osteoporotic medication. Percutaneous vertebroplasty (PVP) and kyphoplasty (KP) are minimal invasive techniques for treatment of symptomatic vertebral compression fractures. The aim of PVP is to obtain partial or complete pain relief by stabilisation of the vertebra with bone cement. KP also offers the possibility to restore vertebral height and decrease kyphotic deformity Retrospective and prospective studies have shown that both PVP and KP are effective and safe. To date, there have been no randomised studies comparing PVP with KP. Therefore, no definite consensus exists regarding treatment choice. In practice, the choice for PVP or KP is mainly based on physician experience or preference. Meanwhile indications for both techniques have broadened. PVP and KP are not only indicated in patients with vertebral compression fractures due to osteoporosis, but also in malignancy and some benign primary bone tumours. In this review article indications, techniques, results and complications of PVP and KP will be discussed. [ABSTRACT FROM AUTHOR]

Vertebrale compressiefracturen (VCF’s) zijn een significante oorzaak van morbiditeit en mortaliteit in de oudere populatie. Osteoporose is de belangrijkste oorzaak van deze fracturen. Voor een VCF bestaan verschillende behandelopties. Doorgaans vindt conservatieve behandeling plaats door middel van bedrust, pijnmedicatie, korset, fysiotherapie en anti-osteoporosemedicatie. Percutane vertebroplastiek (PVP) en kyfoplastiek (KP) zijn minimaal invasieve technieken voor de behandeling van symptomatische VCF’s. Het doel van PVP is partiële of gehele pijnreductie door stabilisatie van een wervel met botcement. KP biedt daarnaast de mogelijkheid de wervelhoogte te herstellen en afname van de kyfotische deformiteit te bewerkstelligen. Uit diverse retro- en prospectieve onderzoeken is reeds gebleken dat PVP en KP veilig en effectief zijn. Vooralsnog zijn geen gerandomiseerde onderzoeken gepubliceerd waarin PVP wordt vergeleken met KP. Er bestaat hierdoor geen eenduidig beleid omtrent de therapiekeuze. De praktijk leert dat de keuze tussen PVP of KP voornamelijk wordt bepaald door de expertise van de behandelend arts met een van de technieken. Inmiddels zijn de indicaties voor beide technieken verruimd. Zowel PVP als KP is geïndiceerd bij een VCF ten gevolge van osteoporose, maligniteiten en enkele benigne primaire bottumoren. In dit overzichtsartikel wordt de huidige stand van zaken met betrekking tot indicaties, technieken, resultaten en complicaties van zowel PVP als KP besproken. Abstractk Vertebral compression fractures are a significant cause of morbidity and mortality in the elderly population. Osteoporosis is the main cause of these fractures. There are several treatment options for a vertebral compression fracture. Treatment usually consists of bed rest, analgetics, bracing, physical therapy and anti-osteoporotic medication. Percutaneous vertebroplasty (PVP) and kyphoplasty (KP) are minimal invasive techniques for treatment of symptomatic vertebral compression fractures. The aim of PVP is to obtain partial or complete pain relief by stabilisation of the vertebra with bone cement. KP also offers the possibility to restore vertebral height and decrease kyphotic deformity. Retrospective and prospective studies have shown that both PVP and KP are effective and safe. To date, there have been no randomised studies comparing PVP with KP. Therefore, no definite consensus exists regarding treatment choice. In practice, the choice for PVP or KP is mainly based on physician experience or preference. Meanwhile indications for both techniques have broadened. PVP and KP are not only indicated in patients with vertebral compression fractures due to osteoporosis, but also in malignancy and some benign primary bone tumours. In this review article indications, techniques, results and complications of PVP and KP will be discussed. [ABSTRACT FROM AUTHOR]

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