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Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures

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.

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Acknowledgements

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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Correspondence to K. Åkesson.

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Boonen, S., Wahl, D.A., Nauroy, L. et al. Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures. Osteoporos Int 22, 2915–2934 (2011). https://doi.org/10.1007/s00198-011-1639-5

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Keywords

  • IOF
  • Kyphoplasty
  • Osteoporosis
  • Pain management
  • Vertebral fractures
  • Vertebroplasty