Percutaneous vertebral augmentation.
BACKGROUND
With the aging of the population, painful osteoporotic compression fractures are becoming more common.


OBJECTIVE
To review the physiologic implications of these injuries as well as treatment options and outcomes, especially with reference to newer, percutaneous "augmentation" procedures, that is, vertebroplasty and kyphoplasty.


METHODS
A literature review.


METHODS
No direct, randomized studies comparing vertebroplasty, kyphoplasty and standard, nonoperative care are available.


RESULTS
The growing literature suggests a role for kyphoplasty and vertebroplasty in the management of patients with intractable pain or progressive vertebral collapse after vertebral compression fracture. Both procedures likely offer similar rates of pain relief. Kyphoplasty, although more expensive, may allow fracture reduction. The void created with the balloon tamp allows a more viscous cement to be applied, thereby decreasing the risk of extravasation.


CONCLUSIONS
More study is required to understand the ideal role of these new techniques in the management of spinal osteoporosis and associated fractures. However, for carefully selected cases, current data suggest that the complication rates are low and pain relief can be profound.
Truumees
Eeric
E
The Rothman Institute and Jefferson Medical College, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107-4216, USA. truumees@comcast.net
Hilibrand
Alan
A
Vaccaro
Alexander R
AR
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D005598:Fractures, Spontaneous / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D010024:Osteoporosis / Q000150:complications* / Q000175:diagnosis; D011187:Posture / Q000502:physiology; D011859:Radiography; D018570:Risk Assessment; D012720:Severity of Illness Index; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome