Comparison of sagittal balance between radiofrequency targeted vertebral augmentation and balloon kyphoplasty in treatment of vertebral compression fracture: A retrospective study

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 ofpatients. In the RF-TVA group, there were no significant differences in percent of vertebral collapse and kyphotic angle between pre-andpost-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.