Vertebroplasty for osteoporotic spine fracture: prevention and treatment
Spine
(2003)
A.
Mehbod, S.
Aunoble, J. C.
Le Huec
Abstract.
There is a relatively high prevalence of osteoporotic vertebral compression fractures (VCFs)
in the elderly population, especially in women aged 50 or older. The result of these VCFs is
increased morbidity and mortality in the short and long term. Medical treatment of these fractures
includes bed rest, orthotics, analgesic medication and time. Percutaneous vertebroplasty (PVP)
consists of percutaneous injection of biomaterial, such as methylmetharylate, into the VCF to produce
stability and pain relief. Biomechanical testing has shown that PVP can restore strength and stiffness
of the vertebral body to the pre-fracture levels. Clinical results show immediate and maintained pain
relief in 70-95% of the patients. Possible major complications include cement leakage into the
spinal canal or into the venous system. Additionally, percutaneous vertebroplasy may alter the normal
loading behavior of the adjacent vertebral body, and there is an increased risk of adjacent segment VCF.
Kyphoplasty is a new technique, which introduces a balloon into the vertebral body transpedicularly to
reduce the VCF while creating a cavity for the cement injection. This technique has the benefit of
kyphosis reduction as well as less cement leakage. Research continues into the development of injectable
biomaterials that are resorbable and allow for new bone formation. Vertebroplasty and kyphoplasty are
safe and effective in the treatment of osteoporotic VCFs. They may allow for a faster return to
function, and thus avoid the morbidity associated with medical treatment.