Introduction: Vertebral fracture is the main complication of osteoporosis and is common among the elderly. Conservative treatment is the first choice for osteoporotic vertebral compression fractures (OVCF) but for persistent painful cases, percutaneous vertebral cement augmentation techniques, such as vertebroplasty and kyphoplasty, are indicated. We performed a systematic review to compare clinical and radiological outcomes of both methods. Methods: A systematic review was performed according to the PRISMA and Cochrane Handbook for Systematic Reviews of Interventions. The PICO search strategy consisted of the following terms: Population- Patients with OVCFs; Intervention- Kyphoplasty; Control- Vertebroplasty; Outcomes- Pain, Cement Leakage, Vertebral Body Height, Adjacent level fractures, Oswestry (ODI) and SF36. Results: Seven articles were included in the qualitative analysis, selecting only randomized controlled trials. Four hundred and fifty patients were treated with vertebroplasty (VP) and 469 with kyphoplasty (KP). The leakage rate of the VP group was 63% versus 14% for the KP group. However, these results were without statistical significance. The Visual Analogue Scale (VAS), ODI and SF-36 outcomes were evaluated based on the 6-month and 1-year follow-up results, and we were unable to find any significant differences between treatments. For restoration of vertebral height, the values of the KP group were, on average, 0.71 cm higher than those of the VP group, with 95% CI. Conclusion: Based on this systematic review, kyphoplasty is superior to vertebroplasty for achieving gains in vertebral body height. As regards cement leakage and other clinical outcomes, neither method showed statistically significant superiority. Level of Evidence I; Systematic review.

Objective: There is still no consensus as to the treatment options for thoracolumbar burst fractures, although these fractures are widely described in the literature. The aim of this study was to evaluate the clinical and radiological outcomes of percutaneous instrumentation without arthrodesis as a method of fixation of these lesions. Methods: This retrospective, cross-sectional study evaluated 16 patients by measuring regional kyphosis using the Cobb method and the scores for quality of life and return to work (Oswestry Disability Index, VAS, SF-36 and Denis). Results: Six months after surgical treatment, 62.5% of all patients showed minimal disability according to the Oswestry Disability Index, maintenance of regional kyphosis correction and no synthesis failure. Conclusions: The clinical and radiological outcomes of the study suggest that minimally invasive fixation is indicated for the treatment of thoracolumbar burst fractures. Level of evidence IV; Observational study: retrospective cohort.