Assessing the Role of Expandable Vertebral Augmentation (EVA) versus high-viscosity cement vertebroplasty (HVCV) in Severe Osteoporotic Vertebral Fracture Management: A Prospective Cohort Study

Area of Science:

• Orthopedics
• Neurosurgery
• Radiology

Background:

• Osteoporotic vertebral compression fractures (OVCFs) are a significant cause of morbidity.
• Severe OVCFs with >40% height loss require effective augmentation techniques.

Purpose of the Study:

• To compare the efficacy of Expandable Vertebral Augmentation (EVA) versus High-Viscosity Cement Vertebroplasty (HVCV).
• To determine superior benefits in patients with severe OVCFs.

Main Methods:

• Prospective cohort study (2018-2020) in Taiwan.
• 98 patients with severe OVCFs (>40% height loss) allocated to EVA or HVCV.
• Primary outcome: radiographic assessment (height restoration, kyphotic angle) at 12 months.

Main Results:

• EVA group showed significantly greater improvement in vertebral body height and kyphotic angle (64.0%) vs. HVCV (40.4%).
• No significant difference in adjacent fractures or cement leakage between groups (p>0.05).
• Both techniques demonstrated comparable safety profiles.

Conclusions:

• Expandable Vertebral Augmentation (EVA) is superior to High-Viscosity Cement Vertebroplasty (HVCV) for vertebral height restoration and kyphotic angle correction.
• Both EVA and HVCV are effective and safe management options for severe OVCFs.