Abstract
Purpose
Vertebral augmentation procedures such as vertebroplasty and kyphoplasty are utilized in the treatment of vertebral compression fractures (VCFs). However, their capacity for providing analgesia, reducing disability, and improving quality of life in patients with osteoporotic VCFs remains a topic of debate. The objective of this narrative review is to summarize the latest evidence for the safety and efficacy of vertebral augmentation for osteoporotic vertebral compression fractures (VCFs).
Methods
A systematic literature search was conducted using the PubMed and Cochrane electronic databases for systematic reviews, review articles, meta-analyses, and randomized clinical trials prior to May 2017. The keywords were “vertebroplasty,” “kyphoplasty,” and “vertebral augmentation.”
Results
Thirty-three papers (7 systematic reviews, 6 cohort studies, 15 randomized clinical trials, and 5 international guidelines) were included in this narrative review.
Conclusion
Vertebral augmentation is a safe procedure, with low rates of serious complications and no increase in subsequent post-treatment fracture risk.
Similar content being viewed by others
References
Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319):1761–1767
Melton LJ III, Lane AW, Cooper C, Eastell R, O'Fallon WM, Riggs BL (1993) Prevalence and incidence of vertebral deformities. Osteoporos Int 3(3):113–119
Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301:513–521
Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, Bauer DC, Genant HK, Haskell WL, Marcus R, Ott SM, Torner JC, Quandt SA, Reiss TF, Ensrud KE (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Lancet 348(9041):1535–1541
Kanis JA, Johnell O (1999) The burden of osteoporosis. J Endocrinol Investig 22:583–588
Buchbinder R, Osborne RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, Graves S, Staples MP, Murphy B (2009) A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 361(6):557–568
Baecker N, Tomic A, Mika C, Gotzmann A, Platen P, Gerzer R, Heer M (2003) Bone resorption is induced on the second day of bed rest. J Appl Physiol 95:977–982
Kortebein P, Symons TB, Ferrando A, Paddon-Jones D, Ronsen O, Protas E, Conger S, Lombeida J, Wolfe R, Evans WJ (2008) Functional impact of 10 days of bed rest in healthy older adults. J Gerontol A Biol Sci Med Sci 63:1076–1081
Kallmes DF, Comstock BA, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH et al (2009) A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 361(6):569–579 Erratum in: N Engl J Med 2012 Mar 8;366(10):970.
McGraw JK, Cardella J, Barr JD, Mathis JM, Sanchez O, Schwartzberg MS, Swan TL, Sacks D, SIR Standards of Practice Committee (2003) Society of Interventional Radiology quality improvement guidelines for percutaneous vertebroplasty. J Vasc Interv Radiol 14:827–831
Ploeg WT, Veldhuizen AG, The B, Sietsma MS (2006) Percutaneous vertebroplasty as a treatment for osteoporotic vertebral compression fractures: a systematic review. Eur Spine J 15:1749–1758
Jensen ME, McGraw JK, Cardella JF, Hirsch JA (2007) Position statement on percutaneous vertebral augmentation: a consensus statement developed by the American Society of Interventional and Therapeutic Neuroradiology, Society of Interventional Radiology, American Association of Neurological Surgeons/congress of neuro- logical surgeons, and American Society of Spine Radiology. J Vasc Interv Radiol 18:325–330
Long SS, Morrison WB, Parker L (2012) Vertebroplasty and kyphoplasty in the United States: provider distribution and guidance method, 2001-2010. AJR Am J Roentgenol 199(6):1358–1364. https://doi.org/10.2214/AJR.12.8733
Hochmuth K, Proschek D, Schwarz W, Mack M, Kurth AA, Vogl TJ (2006) Percutaneous vertebroplasty in the therapy of osteoporotic vertebral compression fractures: a critical review. Eur Radiol 16:998–1004
Voormolen MH, Mali WP, Lohle PN, Fransen H, Lampmann LE, van der Graaf Y, Juttmann JR, Jansssens X, Verhaar HJ (2007) Percutaneous vertebroplasty compared with optimal pain medication treatment. AJNR Am J Neuroradiol 28:555–560
Aebi M (2009) Vertebroplasty: about sense and nonsense of uncontrolled “controlled randomized trials”. Eur Spine J 18:1247–1248
Comstock BA, Sitlani CM, Jarvik JG, Heagerty PJ, Turner JA, Kallmes DF (2013) Investigational vertebroplasty safety and efficacy trial (INVEST): patient-reported outcomes through 1 year. Radiology 269(1):224–231
Manchikanti L, Boswell MV, Kaye AD, Helm IS, Hirsch JA (2017) Therapeutic role of placebo: evolution of a new paradigm in understanding research and clinical practice. Pain Physician 20(5):363–386
Manchikanti L, Knezevic NN, Boswell MV, Kaye AD, Hirsch JA (2016) Epidural injections for lumbar radiculopathy and spinal stenosis: a comparative clinical review and meta-analysis. Pain Physician 19(3):365–410
Klazen CA, Lohle PN, de Vries J, Jansen FH, Tielbeek AV, Blonk MC et al (2010) Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomized trial. Lancet 376(9746):1085–1092
Uppin AA, Hirsch JA, Centenera LV Pfiefer BA, Pazianos AG, Choi IS (2003) Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. Radiology 226(1):119–124
Firanescu C, Lohle PN, de Vries J, Klazen CA, Juttmann JR, Clark W, van Rooij WJ, VERTOS IV study group (2011) A randomised sham controlled trial of vertebroplasty for painful acute osteoporotic vertebral fractures (VERTOS IV). Trials 12:93
Barr JD, Jensen ME, Hirsch JA, McGraw JK, Barr RM, Brook AL, Meyers PM, Munk PL, Murphy KJ, O'Toole JE, Rasmussen PA, Ryken TC, Sanelli PC, Schwartzberg MS, Seidenwurm D, Tutton SM, Zoarski GH, Kuo MD, Rose SC, Cardella JF, Society of Interventional Radiology, American Association of Neurological Surgeons, Congress of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, American Society of Spine Radiology, Canadian Interventional Radiology Association, Society of Neurointerventional Surgery (2014 Feb) Position statement on percutaneous vertebral augmentation: a consensus statement developed by the Society of Interventional Radiology (SIR), American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS), American College of Radiology (ACR), American Society of Neuroradiology (ASNR), American Society of Spine Radiology (ASSR), Canadian Interventional Radiology Association (CIRA), and the Society of NeuroInterventional Surgery (SNIS). J Vasc Interv Radiol 25(2):171–181. https://doi.org/10.1016/j.jvir.2013.10.001
Savage JW, Schroeder GD, Anderson PA (2014) Vertebroplasty and kyphoplasty for the treatment of osteoporotic vertebral compression fractures. J Am Acad Orthop Surg 22(10):653–664. https://doi.org/10.5435/JAAOS-22-10-653
Tsoumakidou G, Too CW, Koch G, Caudrelier J, Cazzato RL, Garnon J, Gangi A (2017 Mar) CIRSE guidelines on percutaneous vertebral augmentation. Cardiovasc Intervent Radiol 40(3):331–342. https://doi.org/10.1007/s00270-017-1574-8
Farrokhi MR, Alibai E, Maghami Z (2011 May) Randomized controlled trial of percutaneous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures. J Neurosurg Spine 14(5):561–569
Anselmetti GC, Marcia S, Saba L, Muto M, Bonaldi G, Carpeggiani P, Marini S, Manca A, Masala S (2012) Percutaneous vertebroplasty: multi-centric results from EVEREST experience in large cohort of patients. Eur J Radiol 81(12):4083–4086. https://doi.org/10.1016/j.ejrad.2012.07.005
Blasco J, Martinez-Ferrer A, Macho J, San Roman L, Pomes J, Carrasco J et al (2012) Effect of vertebroplasty on pain relief, quality of life and the incidence of new vertebral fractures: a 12-month randomized follow-up, controlled trial. J Bone Miner Res 27(5):1159–1166
Buchbinder R, Golmohammadi K, Johnston RV, Owen RJ, Homik J, Jones A, Dhillon SS, Kallmes DF, Lambert RGW, Cochrane Musculoskeletal Group (2015) Percutaneous vertebroplasty for osteoporotic vertebral compression fracture. Cochrane Database Syt Rev 4:CD006349. https://doi.org/10.1002/14651858.CD006349.pub2
Yang EZ, Xu JG, Huang GZ, Xiao WZ, Liu XK, Zeng BF, Lian XF (2016) Percutaneous vertebroplasty versus conservative treatment in aged patients with acute osteoporotic vertebral compression fractures: a prospective randomized controlled clinical study. Spine (Phil Pa 1976) 41(8):653–660
Clark W, Bird P, Gonski P, Diamond TH, Smerdely P, McNeil HP, Schlaphoff G, Bryant C, Barnes E, Gebski V (2016) Safety and efficacy of vertebroplasty for acute painful osteoporotic fractures (VAPOUR): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet 388(10052):1408–1416. https://doi.org/10.1016/S0140-6736(16)31341-1
Bouza C, Lopez T, Magro A, Navalpotro L, Amate JM (2006) Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review. Eur Spine J 15(7):1050–1067
Wardlaw D, Cummings SR, Van Meirhaeghe J, Bastian L, Tillman JB, Ranstam J et al (2009) Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomized controlled trial. Lancet 373:1016–1024. https://doi.org/10.1016/S0140-6736(09)60010-6
Boonen S, Van Meirhaeghe J, Bastian L, Cummings SR, Ranstam J, Tillman JB et al (2011) Balloon kyphoplasty for the treatment of acute vertebral compression fractures: 2-year results from a randomized trial. J Bone Miner Res 26(7):1627–1637
Dohm M, Black CM, Dacre A, Tillman JB, Fueredi G, on behalf of the KAVIAR investigators (2014) A randomized trial comparing balloon kyphoplasty and vertebroplasty for vertebral compression fractures due to osteoporosis. AJNR Am J Neuroradiol 35(12):2227–2236 https://doi.org/10.3174/ajnr.A4127
Wang H, Sribastav SS, Ye F, Yang C, Wang J, Liu H, Zheng Z (2015) Comparison of percutaneous vertebroplasty and balloon kyphoplasty for the treatment of single level vertebral compression fractures: a meta-analysis of the literature. Pain Physician 18:209–222
Marcia S, Saba L, Marras M, Suri JS, Calabria E, Masala S (2016) Percutaneous stabilization of lumbar spine: a literature review and new options in treating spine pain. Br J Radiol 89(1065):20150436
McGirt MJ, Parker SL, Wolinsky JP, Witham TF, Bydon A, Gokaslan ZL (2009) Vertebroplasty and kyphoplasty for the treatment of vertebral compression fractures: an evidenced-based review of the literature. Spine 9(6):501–508
McGraw JK, Cardella J, Barr JD, Mathis JM, Sanchez O, Schwartaberg MS et al (2003) Society of Interventional Radiology Standards of Practice Committee quality improvement guidelines for percutaneous vertebroplasty. J Vasc Interv Radiol 14(1):311–315
Chandra RV, Yoo AJ, Hirsch JA (2013) Vertebral augmentation: update on safety, efficacy, cost-effectiveness and increased survival. Pain Physician 16(4):309–320
Hulme PA, Krebs J, Ferguson SJ, Berlemann U (2006) Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine 31(17):1983–2001
Eck JC, Nachtigall D, Humphreys SC, Hodges SD (2008) Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature. Spine 8(3):488–497
Zhang H, Xu C, Zhang T, Gao Z, Zhang T (2017) Does percutaneous vertebroplasty or balloon kyphoplasty for osteoporotic vertebral compression fractures increase the incidence of new vertebral fractures? A meta-analysis. Pain Physician 20(1):13–28
Chandra RV, Meyers PM, Hirsch JA, Abruzzo T, Eskey CJ, Hussain MS, Lee SK, Narayanan S, Bulsara KR, Gandhi CD, Do HM, Prestigiacomo CJ, Albuquerque FC, Frei D, Kelly ME, Mack WJ, Pride GL, Jayaraman MV, on behalf of the Society of NeuroInterventional Surgery (2014) Vertebral augmentation: report of the Standards and Guidelines Committee of the Society of NeuroInterventional Surgery. J Neurointerv Surg 6:7–15
McCarthy J, Davis A (2016) Diagnosis and management of vertebral compression fractures. Am Fam Physician 94(1):44–50
Hirsch JA, Chandra RV (2016) Resurrection of evidence for vertebroplasty? Lancet 388(10052):1356–1357
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
No funding was received for this study.
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
This article does not contain any studies with human participants performed by any of the authors.
Informed consent
Statement of informed consent was not applicable since the manuscript does not contain any patient data.
Rights and permissions
About this article
Cite this article
Marcia, S., Muto, M., Hirsch, J.A. et al. What is the role of vertebral augmentation for osteoporotic fractures? A review of the recent literature. Neuroradiology 60, 777–783 (2018). https://doi.org/10.1007/s00234-018-2042-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00234-018-2042-0