Year: 2025 | Month: November | Volume: 15 | Issue: 11 | Pages: 262-270
DOI: https://doi.org/10.52403/ijhsr.20251132
Comparison of Percutaneous Vertebroplasty and Kyphoplasty with Open Surgery in Vertebral Compression Fractures
Ravi Kant Pathak1, Apurva Agarwal2, Neetu Singh3, Raghvendra Gupta4, Alok Verma5, Pushpendra Kumar Saini6
1Assistant Professor, Deptt. of Anaesthesiology, GMC, Kannauj
2Professor & Head, Deptt. of Anaesthesiology, GSVM Medical College, Kanpur
3Assistant Professor, Deptt. of Anaesthesiology, BSKIMS, Kanpur
4Professor, Deptt. of Neurosurgery, GSVM Medical College, Kanpur
5Professor, Deptt. of Neurology, GSVM Medical College Kanpur
6Junior Resident, Deptt. of Anaesthesiology, GSVM Medical College, Kanpur, India.
Corresponding Author: Dr. Ravi Kant Pathak
ABSTRACT
Background: Vertebral compression fractures (VCFs) from osteoporosis or malignancy cause severe pain and disability. While open surgery (instrumented decompression/fusion) is the traditional “gold standard,” minimally invasive vertebral augmentation (percutaneous vertebroplasty (PVP) and balloon kyphoplasty (KP) offers rapid pain relief with less morbidity. We prospectively compared PVP/KP versus open surgery in VCF patients on pain relief, mobilization, and functional outcomes.
Methods: Sixty patients with acute thoracolumbar VCFs were randomized: Group A (n=30) underwent PVP/KP under sedation, and Group B (n=30) underwent open surgery. Inclusion criteria included symptomatic one- or two-level thoracolumbar fractures without neurological deficits. Outcomes included visual analogue scale (VAS) pain scores, time to mobilization, duration of analgesia, and Nottingham Pain Profile (NPP) domains.
Results: Groups were demographically similar in age (mean ~51 vs 53 years, p=0.19) and sex ratio (male 96.7% vs 100%, p=0.313). Most patients were urban-dwelling with low socioeconomic status (SES) (no difference in SES distribution, p=0.573). Both treatments produced significant pain reduction. Mean preoperative VAS was ~8.1 in both groups, falling to 2.47±0.51 in the PVP/KP group and 3.10±0.80 in the open-surgery group at 6 months. The PVP/KP group had consistently lower VAS scores at 1, 3, and 6 months (all p<0.001). Group A achieved markedly earlier mobilization (mean 1.97±0.72 days vs 4.33±1.63 days; p<0.001) and longer duration of pain relief (6.13±1.76 vs 5.10±1.86 months; p=0.031). NPP analysis showed dramatic improvement in pain, sleep, physical ability, and emotional domains after PVP/KP, with significantly lower post-treatment scores than in open surgery (e.g. NPP pain: 15.33±8.76 vs 25.83±13.51, p=0.001). Both groups improved on all NPP domains, but the minimally invasive group had better scores in nearly every category.
Conclusion: In VCF patients, percutaneous vertebral augmentation yielded faster pain relief, earlier mobilization, and superior short-term functional outcomes than open surgery, with significantly lower pain and better quality-of-life scores. These findings support the clinical adoption of PVP/KP in appropriately selected VCF patients.
Key words: Vertebroplasty, Kyphoplasty, Vertebral compression fracture, Pain relief, minimally invasive spine surgery, Anaesthesia