Journal List > J Korean Soc Spine Surg > v.22(4) > 1076070

Kim, Ha, and Jung: Percutaneous Vertebral Augmentation for the Treatment of Osteoporotic Spinal Fractures

Abstract

Study Design

Review of the literature.

Objectives

To present updated information on percutaneous vertebral augmentation (PVA) for osteoporotic spinal fractures (OSFs).

Summary of Literature Review

Vertebroplasty and kyphoplasty have been used to treat osteoporotic spinal fractures for many years. A recent meta-analysis provides strong evidence in favor of cement augmentation in the treatment of symptomatic vertebral compression fractures.

Materials and Methods

Review of the relevant literature.

Results

A meta-analysis showed greater pain relief, functional recovery, and improvement in quality of life with cement augmentation compared with control subjects.

Conclusions

Percutaneous vertebral augmentation of osteoporotic spinal fractures results in shorter hospital stays, reduced incidence of complications, and more rapid return of functional independence.

REFERENCES

1. Esses SI, McGuire R, Jenkins J, et al. The treatment of symptomatic osteoporotic spinal compression fractures. J Am Acad Orthop Surg. 2011; 19:176–82.
crossref
2. Barr JD, Jensen ME, Hirsh JA, et al. Position statement on percutaneous vertebral augmentation. J Vasc Interv Radiol. 2014; 25:171–81.
3. Savage JW, Schroeder GD, Anderson PA. Vertebroplasty and kyphoplasty for the treatment of osteoporotic vertebral compression fractures. J Am Acad Orthop Surg. 2014; 22:653–64.
crossref
4. Rousing R, Andersen MO, Jespersen SM, et al. Percutaneous vertebroplasty compared to conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures: three-months followup in a clinical randomized study. Spine (Phila Pa 1976). 2009; 13:1349–54.
5. Papanastassiou ID, Filis A, Gerochristou MA, et al. Con-troversial Issues in kyphoplasty and vertebroplasty in osteoporotic vertebral fractures. Biomed Res Int. 2014 Mar 4. 〔Epub ahead of print〕.
crossref
6. Suzuki N, Ogikubo O, Hansson T. The prognosis for pain, disability, activities of daily living and quality of life after an acute osteoporotic vertebral body fracture: its relation to fracture level, type of fracture and grade of fracture deformation. Eur Spine J. 2009; 18:77–88.
crossref
7. Buchbinder R, Osborne RH, Ebeling PR, et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med. 2009; 361:557–68.
crossref
8. Kallmes DF, Comstock BA, Heagerty PJ, et al. A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med. 2009; 361:569–79.
crossref
9. 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 followup, controlled trial. J Bone Miner Res. 2012; 27:1159–66.
crossref
10. Chen D, An ZQ, Song S, et al. Percutaneous vertebroplasty compared with conservative treatment in patients with chronic painful osteoporotic spinal fractures. J Clin Neurosci. 2014; 21:473–7.
crossref
11. Farrokhi MR, Alibai E, Maghami Z. Randomized controlled trial of percutaneous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures. J Neurosurg Spine. 2011; 14:561–9.
crossref
12. Klazen CA, Lohle PN, de Vries J, et al. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet. 2010; 376(9746):1085–92.
crossref
13. Voormolen MH, Mali WP, Lohle PN, et al. Percutaneous vertebroplasty compared with optimal pain medication treatment: short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures. The VERTOS study. AJNR Am J Neuroradiol. 2007; 28:555–60.
14. Wardlaw D, Cummings SR, Van Meirhaeghe J, et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet. 2009; 373(9668):1016–24.
crossref
15. Liu JT, Liao WJ, Tan WC, et al. Balloon kyphoplasty versus vertebroplasty for treatment of osteoporotic vertebral compression fracture: a prospective, comparative, and randomized clinical study. Osteoporos Int. 2010; 21:359–64.
crossref
16. Dohm M, Black CM, Dacre A, et al. A randomized trial comparing balloon kyphoplasty and vertebroplasty for vertebral compression fractures due to osteoporosis. AJNR Am J Neuroradiol. 2014; 35:2227–36.
crossref
17. Martin DJ, Rad AE, Kallmes DF. Prevalence of extravertebral cement leakage after vertebroplasty: Procedural docu-mentation versus CT detection. Acta Radiol. 2012; 53:569–72.
crossref
18. Verlaan JJ, Dhert WJ, Verbout AJ, et al. Balloon vertebroplasty in combination with pedicle screw instrumentation: A novel technique to treat thoracic and lumbar burst fractures. Spine (Phila Pa 1976). 2005; 30:E73–9.
19. Patel AA, Vaccaro AR, Martyak GG, et al. Neurologic deficit following percutaneous vertebral stabilization. Spine (Phila Pa 1976). 2007; 32:1728–34.
crossref
20. Wang LJ, Yang HL, Shi YX, et al. Pulmonary cement em-bolism associated with percutaneous vertebroplasty or kyphoplasty: A systematic review. Orthop Surg. 2012; 4:182–9.
crossref
21. Anderson PA, Froyshteter AB, Tontz WL Jr. Meta-analysis of vertebral augmentation compared with conservative treatment for osteoporotic spinal fractures. J Bone Miner Res. 2013; 28:372–82.
crossref
22. Zhang Z, Fan J, Ding Q, et al. Risk factors for new osteoporotic vertebral compression fractures after vertebroplasty: A systematic review and meta-analysis. J Spinal Disord Tech. 2013; 26:E150–7.
23. Bono CM, Heggeness M, Mick C, et al. North American Spine Society: Newly released vertebroplasty randomized controlled trials: a tale of two trials. Spine J. 2010; 10:238–40.

Fig. 1.
A 68-year-old woman experienced multiple osteoporotic spinal fractures after a slip in the bathroom (A). After conservative management for 1 month, she still had severe low back pain. A fat-suppressed T2-weighted midsagittal magnetic resonance image shows high signal intensities (arrows) at T11, L1, L2, and L3, which indicates acute fracture (B). Kyphoplasty was performed at L1 and vertebroplasty at T11, L2, and L3 (C). At the 8-month followup, the spinal alignment was good, without kyphotic deformity or vertebral body collapse (D).
jkss-22-192f1.tif
TOOLS
Similar articles