A Randomized Trial Comparing 2 Techniques of Balloon Kyphoplasty and Curette Use for Obtaining Vertebral Body Height Restoration and Angular-Deformity Correction in Vertebral Compression Fractures due to Osteoporosis

Primary end point of absolute height restored at index vertebrae as a percentage of adjacent normal vertebrae. Group means and 95% confidence intervals are shown for measurements at the posterior, anterior, and midpoint of index vertebral bodies for each group at baseline and at 48 hours postoperatively by using standing lateral x-ray films.

Index vertebral body height gain in millimeters. CF (A) and IBTF (B) group means and 95% confidence intervals are shown for vertebral body height improvement (compared with preoperative) in millimeters, measured at the posterior, anterior, and midpoint of index vertebral bodies after prone positioning (postural reduction), IBT inflation, cementation, and postoperative steps. Preoperative and postoperative assessments used standing lateral x-rays, and intraoperative assessments used lateral fluoroscopic images.

Index vertebral body kyphosis angle. CF (A) and IBTF (B) group means and 95% confidence intervals are shown for kyphotic angulation improvement (compared with preoperative) of index vertebral bodies measured as the angle between the inferior and superior endplates of index vertebrae after prone positioning (postural reduction), IBT inflation, cementation, and postoperative steps. Preoperative and postoperative assessments used standing lateral x-rays, and intraoperative assessments used lateral fluoroscopic images.

Case illustration of kyphosis correction for each step in the kyphoplasty procedure. A, Preoperative T2 short-τ inversion recovery MR imaging. B, Preoperative standing x-ray. C, Intraoperative postural reduction without bolsters. D, Intraoperative postural reduction with a bolster. E, Intraoperative first balloon inflation. F, Intraoperative curette and second balloon inflation. G, Intraoperative cement placement. H, Postoperative standing x-ray.

Case illustration of a nonmobile fracture. A, Preoperative standing x-ray. B, Intraoperative postural reduction with a bolster. C, Intraoperative first balloon inflation. D, Intraoperative curette and second balloon inflation. E, Intraoperative cement placement. F, Postoperative standing x-ray.

Case illustration of nonmobile fracture and use of curette. A, Intraoperative postural reduction with a bolster. B, Intraoperative first balloon inflation. C, Intraoperative curette usage (used bilaterally but image shows use only on 1 side). D, Intraoperative second balloon inflation. E, Anteroposterior (AP) film of C. F, AP film of D. G, Intraoperative cement placement. H, Postoperative standing x-ray.