Vertebroplasty for acute painful osteoporotic vertebral compression fractures: An update

Abstract

Summary Vertebral compression fractures (VCFs) are a common cause of back pain and disability and are usually osteoporotic in nature. Therapy aims to adequately control pain and allow early mobilisation and return of function while preventing additional fractures. A proportion of patients do not achieve adequate pain relief using conservative measures alone. Unwanted adverse effects from medications may also ensue. Vertebroplasty represents an alternative treatment option for VCFs. Patients with acute VCFs (≤6 weeks old) may gain the most benefit from vertebroplasty as healed fractures are not as amenable to cement injection. High‐quality studies have reported conflicting results regarding the use of vertebroplasty in the treatment of acute VCFs. Despite high‐quality evidence, varying study designs and heterogenous patient cohorts make interpretation of this data difficult. Only one sham‐controlled randomised controlled trial (RCT) has evaluated vertebroplasty exclusively in patients with acute VCFs, reporting favourable results. Pooled data from RCTs also suggest vertebroplasty to be safe. This article provides a concise and critical review of the current literature regarding vertebroplasty for the treatment of acute VCFs.

Performance of Double-Arm Digital Subtraction Angiography (DSA)-Guided and C-Arm-Guided Percutaneous Kyphoplasty (PKP) to Treat Senile Osteoporotic Vertebral Compression Fractures

“…PKP is minimally invasive spinal surgery that has been widely used in clinical practice. It is mainly used to inject bone cement into the vertebral body after balloon expansion under the guidance of the C-arm [ 11 , 26 ]. After the cement hardens, it improves stability of the spine.…”

“…Osteoporotic vertebral compression fracture (OVCF) is common in the elderly [ 9 ], leading to symptoms of pain, height loss, curvature of the spine, and body shape change, and it is even linked to mortality. Traditional treatment leads to prolonged bed rest, which may cause serious complications [ 10 , 11 ]. Patients suffering from OVCF also have conditions related to reduced quality of bones, such as bone damage.…”

Vertebroplasty in Osteoporotic Vertebral Fractures: Technical Considerations and Complications

“…In our study, we have used 2-3 mL of high-viscosity PMMA and hence did not encounter any major extravasation. According to a recent update, 17 the optimal volume of cement is still an ongoing area of research. [18][19][20] In the VAPOUR study (the fixed double-blinded sham-controlled RCT to evaluate vertebroplasty exclusively in patients with vertebral compression fracture less than 6 weeks old), vertebroplasty resulted in a significantly improved general quality of life.…”

Comparison of Percutaneous Kyphoplasty with or without Pedicle Screw Fixation in Osteoporotic Thoracolumbar Vertebral Fractures: A Retrospective Study

“…With around 1.4 million new cases every year, it has become a great social, health, and economic burden since patients will be unable to perform daily activities due to severe back pain [ 1 ]. Over the past decades, percutaneous kyphoplasty (PKP) has been widely used for the treatment of osteoporosis and vertebral compression fractures, because it is a minimal invasive surgery to achieve many benefits on short-term prognosis including pain relief, shortened hospital stay, and restoration of vertebral body height [ 2 ]. Hu et al reported that after percutaneous balloon kyphoplasty, 91 patients with osteoporotic vertebral compression fracture achieved satisfactory improvement in visual analogue scale (VAS), Cobb angle (CA), and anterior vertebra height rate (AVHr) compared with those preoperative indices ( p < 0.05) [ 3 ].…”