Comparison of Sagittal Balance between Radiofrequency
Targeted Vertebral Augmentation and Balloon
Kyphoplasty in Treatment of Vertebral Compression
Fracture: A Retrospective Study
Werasak Sutipornpalangkul PhD, MD*, Lester Zambrana BSc**,
Arianna Gianakos BSc**, Joseph M Lane MD**
Affiliation :
* Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
** Hospital for Special Surgery, Weill Cornell Medical College New York, NY, USA
Objective : To compare the effectiveness of high viscosity cement radiofrequency targeted vertebral augmentation (RF-TVA)
and balloon kyphoplasty on spinal sagittal balance through radiologic evaluation.
Material and Method: The present retrospective study included patients whom underwent either balloon kyphoplasty
utilizing the Kyphon system or RF-TVA utilizing the DFine system between 2007 and 2014. Medical record reviews included
demographic data and radiographic findings including pre- and post-operative lateral radiographs of the whole spine and
post-operative computerized topography. All spinal sagittal alignment parameters such as pelvic incidence (PI), sacral
slope (SS), pelvic tilt (PT), lumbar lordosis (LL), sagittal vertical axis (SVA), and spinosacral angle (SSA) were measured
and evaluated.
Results : Thirty-three vertebral compression fracture (VCF) patients were included in the present study. Sixteen of them
underwent RF-TVA and 17 underwent balloon kyphoplasty. There were no significant differences in age, gender, and
pre-operative spinal sagittal alignment parameters between these two groups of patients. In the RF-TVA group, there were
no significant differences in percent of vertebral collapse and kyphotic angle between pre-and post-operative radiographs.
In the balloon kyphoplasty group, there were significant improvement in both percent of vertebral collapse and kyphotic
angle. The balloon kyphoplasty group also showed a statistically significant change in pelvic tilt (p = 0.02). Neither group
demonstrated statistically significant changes in any other spinal sagittal alignment parameters (p>0.05).
Conclusion : The RF-TVA and balloon kyphoplasty did not play a role in improving the whole spine alignment in the treatment
of VCF. However, balloon kyphoplasty did demonstrate regional improvement of the VCF.
Keywords : Kyphoplasty, Sagittal balance, Osteoporosis, Vertebral compression fracture
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