A comparison of two new technologies for percutaneous vertebral augmentation: Confidence vertebroplasty vs. sky kyphoplasty

Background: Cement vertebroplasty has been performed for over a decade to treat painful osteoporotic vertebral compression fractures (OVCFs). Kyphoplasty is considered a further step in the evolution of vertebral augmentation. Objectives: To evaluate the efficiency and safety of two systems to treat OVCF: Confidence Vertebroplasty (CV) compared to Sky Kyphoplasty (SK). Methods: This prospective study included 45 patients with OVCF. Fourteen were treated with CV and 31 with SK. An imaging evaluation using a compression ratio (height of anterior vs. posterior wall) and local kyphotic deformity (Cobb angle) was performed prior to the procedure and 12 months later. Evaluation of pain was carried out using a visual analogue scale. Results: The mean compression repair was 12% in the CV group compared to 25% in the SK group. Mean kyphotic deformity restoration achieved using CV was 41% compared to 67% using SK. In both groups the pain severity was equally reduced by a mean of 43%. Conclusions: The SK system is technically superior in restoring the vertebral height and repairing the kyphotic deformity, an advantage that was not manifested in pain relief - the most important variable. Both systems have a high level of safety. The cost-benefit balance clearly favors the CV system.