title: Is kyphoplasty the standard of care for compression fractures in the spine, especially in the elderly?
abstract: Vertebral fractures, particularly if they are nonsymptomatic, are old, and have not produced kyphotic deformity, should be treated with conservative care, including appropriate medical management. Those fractures that are symptomatic, produce pain that persists over several weeks (4 out of 10 on the visual analog score), and have resulted in some kyphotic deformity should be treated with a vertebroplasty or kyphoplasty. Patients with kyphotic deformity of less than 20% can obtain pain relief from vertebroplasty that is comparable to pain relief from kyphoplasty. For patients with a greater degree of kyphosis, only kyphoplasty can offer the predictable restoration of height and realignment of the spine. Currently we treat all Colles' fractures, all hip fractures, and all tibia plateau fractures. The time has come to treat all symptomatic vertebral fractures.
authors.affiliation: Hospital for Special Surgery, New York, New York, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Neviaser
authors.forename: Jose B
authors.initials: JB
authors.lastname: Toro-Arbelaez
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Lane
mesh_terms: D000368:Aged; D005593:Fracture Fixation, Internal / Q000379:methods*; D050815:Fractures, Compression / Q000150:complications* / Q000601:surgery; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D019904:Polymethyl Methacrylate; D019919:Prosthesis Implantation / Q000295:instrumentation; D016103:Spinal Fractures / Q000150:complications* / Q000601:surgery; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery
chemical_list: D019904:Polymethyl Methacrylate