Osteoporosis International

, Volume 22, Issue 12, pp 2915–2934 | Cite as

Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures

  • S. Boonen
  • D. A. Wahl
  • L. Nauroy
  • M. L. Brandi
  • M. L. Bouxsein
  • J. Goldhahn
  • E. M. Lewiecki
  • G. P. Lyritis
  • D. Marsh
  • K. Obrant
  • S. Silverman
  • E. Siris
  • K. ÅkessonEmail author
  • for the CSA Fracture Working Group of the International Osteoporosis Foundation


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.


IOF Kyphoplasty Osteoporosis Pain management Vertebral fractures Vertebroplasty 



The Fracture Working Group of the IOF Committee of Scientific Advisors was supported by the International Osteoporosis Foundation. None of the authors were compensated for their contribution. Dr. Boonen is senior clinical investigator of the Fund for Scientific Research, Flanders, Belgium (F.W.O.-Vlaanderen) and holder of the Leuven University Chair in Gerontology and Geriatrics.

Conflicts of interest

Steven Boonen has received research funding and consulting fees from Medtronic—but no compensation in relation to this manuscript. All other authors have no competing interests to declare.


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  • S. Boonen
    • 1
  • D. A. Wahl
    • 2
  • L. Nauroy
    • 2
  • M. L. Brandi
    • 3
  • M. L. Bouxsein
    • 4
  • J. Goldhahn
    • 5
  • E. M. Lewiecki
    • 6
  • G. P. Lyritis
    • 7
  • D. Marsh
    • 8
  • K. Obrant
    • 9
  • S. Silverman
    • 10
  • E. Siris
    • 11
  • K. Åkesson
    • 12
    Email author
  • for the CSA Fracture Working Group of the International Osteoporosis Foundation
  1. 1.Division of Gerontology and Geriatrics and Center for Musculoskeletal Research, Department of Experimental MedicineLeuven UniversityLeuvenBelgium
  2. 2.International Osteoporosis FoundationNyonSwitzerland
  3. 3.Department of Internal MedicineUniversity of FlorenceFlorenceItaly
  4. 4.Department of Orthopedic SurgeryHarvard Medical SchoolBostonUSA
  5. 5.AO Clinical Priority Program Fracture Fixation in Osteoporotic BoneETH: Institute for Biomechanics of ETH ZurichZurichSwitzerland
  6. 6.New Mexico Clinical Research & Osteoporosis CenterAlbuquerqueUSA
  7. 7.Laboratory for the Research of the Musculoskeletal SystemUniversity of Athens, KAT HospitalKifissiaGreece
  8. 8.Institute of Orthopaedics and Musculoskeletal ScienceUniversity College London, Royal National Orthopaedic HospitalStanmoreUK
  9. 9.Department of OrthopaedicsSkåne University HospitalMalmöSweden
  10. 10.Department of Medicine and RheumatologyCedars-Sinai Medical CenterBeverly HillsUSA
  11. 11.Toni Stabile Osteoporosis CenterColumbia University Medical CenterNew YorkUSA
  12. 12.Department of OrthopedicsSkåne University Hospital Malmö, Lund UniversityMalmöSweden

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