Semin Musculoskelet Radiol 2016; 20(04): 382-391
DOI: 10.1055/s-0036-1592431
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Vertebroplasty and Kyphoplasty in Vertebral Osteoporotic Fractures

Francisco Aparisi
1   Hospital Nueve de Octubre, Valencia, Valencia, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
14 November 2016 (online)

Abstract

Vertebroplasty and kyphoplasty are minimally invasive treatments and indispensable tools in the treatment of osteoporotic compression fractures. This method of treatment is performed using fluoroscopy or a scanner control an access via the pedicle or the posterolateral angle of the vertebral body. Vertebroplasty requires a smaller caliber needle than kyphoplasty, so it is technically easier. Vertebroplasty uses high-pressure injection, whereas in kyphoplasty the injection is held at low pressure, which together with the effect of compression on the bone that the balloon produces reduces the risk and rate of cement leakage. Vertebroplasty is effective in managing osteoporotic compression vertebral fractures, with improvement in pain and quality of life in the immediate postoperative period and over the medium term.

Both techniques have a very low complication rate. There is no consensus on whether the emergence of new fractures in the cases treated by vertebroplasty and kyphoplasty are related to mechanical variations that were introduced or is a complication related to the age and evolution of the patient's osteoporosis. Even with this risk of new fractures, the improvement in quality of life obtained after vertebroplasty and kyphoplasty treatment is worthwhile. The benefits outweigh the risks.

 
  • References

  • 1 International Osteoporosis Foundation. Osteoporosis and musculoskeletal disorders. Available https://www.iofbonehealth.org/osteoporosis-musculoskeletal-disorders . Accessed September 13, 2016
  • 2 Knaub J. Vertebroplasty controversy: two new studies question decades of clinical experience. Radiology Today 2009; 10 (15) 20
  • 3 Santos RF, Ribeiro JC, de Moraes FB, Cardoso AL, Pimenta Junior WE, Daher MT. Evaluation of the quality of life after vertebroplasty to treat compressive osteoporotic fractures. Rev Bras Ortop 2014; 49 (5) 477-481
  • 4 Li L, Ren J, Liu J , et al LiL. Results of vertebral augmentation treatment for patients of painful osteoporotic vertebral compression fractures: a meta-analysis of eight randomized controlled trials. PLoS ONE 2015; 10 (9) e0138126
  • 5 Amerigo-Garcia MJ, Antolin-Arias J. Vertebroplasty: an alternative therapy for painful osteoporosis vertebral fractures which do not respond to conservative treatment? Review and update. Rev Osteoporos Metab Miner 2010; 1: 31-36
  • 6 Blasco J, Martinez-Ferrer A, Macho J , et al. Effect of vertebroplasty on pain relief, quality of life, and the incidence of new vertebral fractures: a 12-month randomized follow-up, controlled trial. J Bone Miner Res 2012; 27 (5) 1159-1166
  • 7 Chiras J, Barragán-Campos HM, Cormier E, Jean B, Rose M, LeJean L. Vertebroplasty: state of the art [in French]. J Radiol 2007; 88 (9 Pt 2) 1255-1260
  • 8 Laredo JD, Hamze B. Complications of percutaneous vertebroplasty and their prevention. Semin Ultrasound CT MR 2005; 26 (2) 65-80
  • 9 Xie W, Jin D, Wan C , et al. The incidence of new vertebral fractures following vertebral augmentation: a meta-analysis of randomized controlled trials. Medicine (Baltimore) 2015; 94 (37) e1532
  • 10 Trout AT, Kallmes DF, Kaufmann TJ. New fractures after vertebroplasty: adjacent fractures occur significantly sooner. AJNR Am J Neuroradiol 2006; 27 (1) 217-223
  • 11 Zhai W, Jia Y, Wang J , et al. The clinical effect of percutaneous kyphoplasty for the treatment of multiple osteoporotic vertebral compression fractures and the prevention of new vertebral fractures. Int J Clin Exp Med 2015; 8 (8) 13473-13481