RT info:eu-repo/semantics/article
T1 A prospective, international, randomized, noninferiority study comparing an implantable titanium vertebral augmentation device versus balloon kyphoplasty in the reduction of vertebral compression fractures (SAKOS study)
A1 Noriega González, David César
A1 Marcia, Stefano
A1 Theumann, Nicolas
A1 Blondel, Benjamin
A1 Simon, Alexandre
A1 Hassel, Frank
A1 Maestretti, Gianluca
A1 Petit, Antoine
A1 Weidle, Patrick A.
A1 González Mandly, Andrés
A1 Kaya, Jean-Marc
A1 Touta, Adamou
A1 Fuentes, Stéphane
A1 Pflugmacher, Robert
K1 Adjacent fractures
K1 Fracturas adyacentes
K1 Balloon kyphoplasty
K1 Cifoplastia con balón
K1 Osteoporosis
K1 Spine surgery
K1 Cirugía de columna
AB Background context: Balloon kyphoplasty (BKP) is a commonly performed vertebral augmentation procedure for painful osteoporotic vertebral compression fractures (OVCFs). Objective: This study aimed to support a non-inferiority finding for the use of a titanium implantable vertebral augmentation device (TIVAD) compared to BKP. Study design: Prospective, parallel group, controlled comparative randomized study. Patient sample: Patients who presented with one or two painful OVCFs located between T7 and L4 aged <3 months, failed conservative treatment, and had an Oswestry Disability Index (ODI) score ≥30/100 were eligible for the study.  Results: Among the 141 patients (78.7% female, mean age 73.3±9.5 years) who underwent surgery (TIVAD=68; BKP=73), 126 patients (89.4%) completed the 12-month follow-up period (TIVAD=61; BKP=65). The analysis of primary endpoint on the ITT population demonstrated non-inferiority of the TIVAD to BKP. The analysis of the additional composite endpoint demonstrated the superiority of TIVAD over BKP (p<0.0001) at 6 months (88.1% vs. 60.9%) and at 12 months (79.7% vs. 59.3%). Midline VB height restoration was more improved for TIVAD than for BKP at 6 months (1.14±2.61 mm vs. 0.31±2.22 mm); p=0.0246) and 12 months after surgery (1.31±2.58 mm vs. 0.10±2.34 mm; p=0.0035). No statistically significant differences were shown between procedures for improvement in functional capacity and quality of life. Pain relief was significantly more marked in the TIVAD group compared to the BKP group at 1 month (p=0.029) and at 6 months (p=0.021) after surgery. No patient required surgical reintervention or retreatment at the treated level. No symptomatic cement leakage was reported. Adverse events were similar for both groups (41.2% in the TIVAD group and 45.2% in the BKP group). The incidence of adjacent fractures was significantly lower after the TIVAD procedure than after BKP (12.9% vs. 27.3%; p=0.043). Conclusions: Study results demonstrated non-inferiority of the TIVAD to the predicate BKP with an excellent risk/benefit profile for results up to 12 months.
PB Elsevier
SN 1529-9430
YR 2019
FD 2019
LK http://uvadoc.uva.es/handle/10324/44980
UL http://uvadoc.uva.es/handle/10324/44980
LA eng
NO The Spine Journal, 2019, vol. 19, n. 11. p. 1782-1795
NO Producción Científica
DS UVaDOC
RD 20-abr-2024