Review

Osteoporosis International

, Volume 22, Issue 12, pp 2915-2934

Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures

  • S. BoonenAffiliated withDivision of Gerontology and Geriatrics and Center for Musculoskeletal Research, Department of Experimental Medicine, Leuven University
  • , D. A. WahlAffiliated withInternational Osteoporosis Foundation
  • , L. NauroyAffiliated withInternational Osteoporosis Foundation
  • , M. L. BrandiAffiliated withDepartment of Internal Medicine, University of Florence
  • , M. L. BouxseinAffiliated withDepartment of Orthopedic Surgery, Harvard Medical School
  • , J. GoldhahnAffiliated withAO Clinical Priority Program Fracture Fixation in Osteoporotic Bone, ETH: Institute for Biomechanics of ETH Zurich
  • , E. M. LewieckiAffiliated withNew Mexico Clinical Research & Osteoporosis Center
  • , G. P. LyritisAffiliated withLaboratory for the Research of the Musculoskeletal System, University of Athens, KAT Hospital
  • , D. MarshAffiliated withInstitute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital
    • , K. ObrantAffiliated withDepartment of Orthopaedics, Skåne University Hospital
    • , S. SilvermanAffiliated withDivision of Gerontology and Geriatrics and Center for Musculoskeletal Research, Department of Experimental Medicine, Leuven UniversityDepartment of Medicine and Rheumatology, Cedars-Sinai Medical Center
    • , E. SirisAffiliated withDivision of Gerontology and Geriatrics and Center for Musculoskeletal Research, Department of Experimental Medicine, Leuven UniversityToni Stabile Osteoporosis Center, Columbia University Medical Center
    • , K. ÅkessonAffiliated withDivision of Gerontology and Geriatrics and Center for Musculoskeletal Research, Department of Experimental Medicine, Leuven UniversityDepartment of Orthopedics, Skåne University Hospital Malmö, Lund University Email author 
    • , for the CSA Fracture Working Group of the International Osteoporosis Foundation

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Abstract

Vertebral compression fractures (VCFs) are the most prevalent fractures in osteoporotic patients. The classical conservative management of these fractures is through rest, pain medication, bracing and muscle relaxants. The aim of this paper is to review prospective controlled studies comparing the efficacy and safety of minimally invasive techniques for vertebral augmentation, vertebroplasty (VP) and balloon kyphoplasty (BKP), versus non-surgical management (NSM). The Fracture Working Group of the International Osteoporosis Foundation conducted a literature search and developed a review paper on VP and BKP. The results presented for the direct management of osteoporotic VCFs focused on clinical outcomes of these three different procedures, including reduction in pain, improvement of function and mobility, vertebral height restoration and decrease in spinal curvature (kyphosis). Overall, VP and BKP are generally safe procedures that provide quicker pain relief, mobility recovery and in some cases vertebral height restoration than conventional conservative medical treatment, at least in the short term. However, the long-term benefits and safety in terms of risk of subsequent vertebral fractures have not been clearly demonstrated and further prospective randomized studies are needed with standards for reporting. Referral physicians should be aware of VP/BKP and their potential to reduce the health impairment of patients with VCFs. However, VP and BKP are not substitutes for appropriate evaluation and treatment of osteoporosis to reduce the risk of future fractures.

Keywords

IOF Kyphoplasty Osteoporosis Pain management Vertebral fractures Vertebroplasty