Skip to main content
SpringerLink
Log in

Outcomes of Balloon Kyphoplasty for the Treatment of Osteoporotic Vertebral Compression Fracture in Rheumatoid Arthritis: A Case-control Study

  • Original Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Background

Patients with rheumatoid arthritis (RA) have higher rate of osteoporosis and vertebral fracture than individuals without RA. This study aimed to compare the outcomes of balloon kyphoplasty (KP) performed to treat osteoporotic vertebral compression fracture (OVCF) in RA patients with the outcomes in non-RA patients.

Materials and Methods

The patients who received KP for OVCF and could be followed up at least 1 year were included in the study. These patients were divided into RA group and non-RA group. For clinical outcomes, the visual analog scale for back pain (VAS-BP) and Korean version of the Oswestry Disability Index (K-ODI) were assessed before and after the procedure and at the 1-year followup. For radiological outcomes, the anterior vertebral height and change in local kyphotic angle were measured. Complications were also examined.

Results

Twenty three RA patients (31 vertebral bodies) and 107 non-RA patients (124 vertebral bodies) were analyzed. In two groups, postoperative VAS-BP and K-ODI decreased significantly to similar extents. There was a similar recovery of vertebral height and kyphotic angle in two groups. However, in terms of complications, adjacent segment fracture and recollapse were more frequent in the RA group than in the non-RA group.

Conclusions

The use of KP to treat OVCF in RA group exhibited similar outcomes to non-RA group in terms of pain reduction, vertebral height restoration, and kyphosis correction. However, RA group had significantly higher rate of complications involving adjacent segment fracture and recollapse. Therefore, careful followup after KP in patients with RA is required to monitor for high complication rate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Haugeberg G, Uhlig T, Falch JA, Halse JI, Kvien TK. Bone mineral density and frequency of osteoporosis in female patients with rheumatoid arthritis: Results from 394 patients in the Oslo County Rheumatoid Arthritis Register. Arthritis Rheum 2000;43:522–30.

    Article  CAS  PubMed  Google Scholar 

  2. Sinigaglia L, Nervetti A, Mela Q, Bianchi G, Del Puente A, Di Munno O, et al. A multicenter cross sectional study on bone mineral density in rheumatoid arthritis. Italian Study Group on Bone Mass in Rheumatoid Arthritis. J Rheumatol 2000;27:2582–9.

    CAS  PubMed  Google Scholar 

  3. Haugeberg G, Uhlig T, Falch JA, Halse JI, Kvien TK. Reduced bone mineral density in male rheumatoid arthritis patients: Frequencies and associations with demographic and disease variables in ninety-four patients in the Oslo County Rheumatoid Arthritis Register. Arthritis Rheum 2000;43:2776–84.

    Article  CAS  PubMed  Google Scholar 

  4. Hooyman JR, Melton LJ 3rd, Nelson AM, O’Fallon WM, Riggs BL. Fractures after rheumatoid arthritis. A population-based study. Arthritis Rheum 1984;27:1353–61.

    Article  CAS  PubMed  Google Scholar 

  5. Peel NF, Moore DJ, Barrington NA, Bax DE, Eastell R. Risk of vertebral fracture and relationship to bone mineral density in steroid treated rheumatoid arthritis. Ann Rheum Dis 1995;54:801–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Papanastassiou ID, Phillips FM, Van Meirhaeghe J, Berenson JR, Andersson GB, Chung G, et al. Comparing effects of kyphoplasty, vertebroplasty, and non-surgical management in a systematic review of randomized and non-randomized controlled studies. Eur Spine J 2012;21:1826–43.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988;31:315–24.

    Article  CAS  PubMed  Google Scholar 

  8. Lieberman IH, Dudeney S, Reinhardt MK, Bell G. Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fracture. Spine (Phila Pa 1976) 2001;26:1631–8.

    Article  CAS  Google Scholar 

  9. Hauser B, Riches PL, Wilson JF, Horne AE, Ralston SH. Prevalence and clinical prediction of osteoporosis in a contemporary cohort of patients with rheumatoid arthritis. Rheumatology (Oxford) 2014;53:1759–66.

    Article  CAS  Google Scholar 

  10. Suh SP, Kim CW, Jo YH, Kang CN. Height restoration after balloon kyphoplasty in rheumatoid patients with osteoporotic vertebral compression fracture. Asian Spine J 2015;9:581–6.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Movrin I, Vengust R, Komadina R. Adjacent vertebral fractures after percutaneous vertebral augmentation of osteoporotic vertebral compression fracture: A comparison of balloon kyphoplasty and vertebroplasty. Arch Orthop Trauma Surg 2010;130:1157–66.

    Article  CAS  PubMed  Google Scholar 

  12. Wardlaw D, Cummings SR, Van Meirhaeghe J, Bastian L, Tillman JB, Ranstam J, et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): A randomised controlled trial. Lancet 2009;373:1016–24.

    Article  PubMed  Google Scholar 

  13. Frankel BM, Monroe T, Wang C. Percutaneous vertebral augmentation: An elevation in adjacent-level fracture risk in kyphoplasty as compared with vertebroplasty. Spine J 2007;7:575–82.

    Article  PubMed  Google Scholar 

  14. Kayanja MM, Evans K, Milks R, Lieberman IH. Adjacent level load transfer following vertebral augmentation in the cadaveric Spin. Spine (Phila Pa 1976) 2006;31:E790-7.

    Article  Google Scholar 

  15. Rho YJ, Choe WJ, Chun YI. Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty. Eur Spine J 2012;21:905–11.

    Article  PubMed  Google Scholar 

  16. Rohlmann A, Zander T, Bergmann G. Spinal loads after osteoporotic vertebral fractures treated by vertebroplasty or kyphoplasty. Eur Spine J 2006;15:1255–64.

    Article  PubMed  Google Scholar 

  17. Spross C, Aghayev E, Kocher R, Röder C, Forster T, Kuelling FA, et al. Incidence and risk factors for early adjacent vertebral fractures after balloon kyphoplasty for osteoporotic fractures: Analysis of the SWISSspine registry. Eur Spine J 2014;23:1332–8.

    Article  PubMed  Google Scholar 

  18. Harrop JS, Prpa B, Reinhardt MK, Lieberman I. Primary and secondary osteoporosis’ incidence of subsequent vertebral compression fractures after kyphoplast. Spine (Phila Pa 1976) 2004;29:2120–5.

    Article  Google Scholar 

  19. Syed MI, Patel NA, Jan S, Shaikh A, Grunden B, Morar K, et al. Symptomatic refractures after vertebroplasty in patients with steroid-induced osteoporosis. AJNR Am J Neuroradiol 2006;27:1938–43.

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Walsh LJ, Lewis SA, Wong CA, Cooper S, Oborne J, Cawte SA, et al. The impact of oral corticosteroid use on bone mineral density and vertebral fracture. Am J Respir Crit Care Med 2002;166:691–5.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, South Korea

    Kyu-Tae Hwang, Young-Il Ko, Sang Hoon Park, Seung Gun Lee &  Chang-Nam Kang

Authors
  1. Kyu-Tae Hwang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Young-Il Ko
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sang Hoon Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Seung Gun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chang-Nam Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chang-Nam Kang.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hwang, KT., Ko, YI., Park, S.H. et al. Outcomes of Balloon Kyphoplasty for the Treatment of Osteoporotic Vertebral Compression Fracture in Rheumatoid Arthritis: A Case-control Study. JOIO 53, 763–768 (2019). https://doi.org/10.4103/ortho.IJOrtho_405_18

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/ortho.IJOrtho_405_18

Keywords

Search

Navigation