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.

Balloon osteoplasty—a new technique for minimally invasive reduction and stabilisation of Hill–Sachs lesions of the humeral head: a cadaver study

“…We show in a preliminary cadaver feasibility study successful use of the kyphoplasty balloon system for reducing humeral head fractures. The kyphoplasty system has been used for many years in fracture treatment of vertebral bodies, and as its use has increased [32], it is also increasingly popular to reduce other impression fractures [33]. Its extravertebral application is thus spreading and the technique has been described for reducing tibial plateau [33], distal radius [34], displaced calcaneus and even acetabular fractures [35].…”

Vertebroplasty and Kyphoplasty for Osteoporotic Vertebral Fractures: What Are the Latest Data?

“…There was durable reduction in back pain NRS scores but no difference in the Short-Form-36 or Roland Morris Disability Questionnaire (RDQ) scores at 24 months. 19 Anatomic outcomes were durable:…”

Anterior Lumbar Interbody Fusion With Cement Augmentation Without Posterior Fixation to Treat Isthmic Spondylolisthesis in an Osteopenic Patient—A Surgical Technique

“…10 Vertebroplasty has long been utilized in the treatment of osteoporotic vertebral compression fractures to strengthen the vertebral body, but this procedure has significant risks associated with cement extravasation. 27,28 Leakage of the cement, either by way of migration across fractured vertebral body cortex or into external venous plexus, can cause severe complications, including neural compression and cement embolus, respectively.…”