title: A review of vertebroplasty for osteoporotic and malignant vertebral compression fractures.
abstract: Vertebral compression fractures are a common clinical problem and the incidence of them will increase with the ageing population. Traditionally management has been conservative; however, there has been a growing trend towards vertebroplasty as an alternative therapy in patients with persisting severe pain. NICE produced guidance in 2003 recommending the procedure after 4 weeks of conservative management. Recent high-quality studies have been contradictory and there is currently a debate surrounding the role of the procedure with no agreement in the literature. We examine the evidence in both osteoporotic and malignant vertebral compression fractures; we also describe the benefits and side effects, alternative treatment options and the cost of the procedure. Finally, we recommend when vertebroplasty is most appropriately used based on the best available evidence.
authors.affiliation: Department of Elderly Care, Royal Berkshire Hospital, Royal Berkshire NHS Foundation Trust, London Road, Reading RG1 5AN, UK. alexandramontagu@yahoo.com
authors.forename: Alexandra
authors.initials: A
authors.lastname: Montagu
authors.forename: Archie
authors.initials: A
authors.lastname: Speirs
authors.forename: James
authors.initials: J
authors.lastname: Baldock
authors.forename: James
authors.initials: J
authors.lastname: Corbett
authors.forename: Margot
authors.initials: M
authors.lastname: Gosney
mesh_terms: D000367:Age Factors; D000368:Aged; D003362:Cost-Benefit Analysis; D019317:Evidence-Based Medicine; D005260:Female; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000191:economics / Q000209:etiology / Q000628:therapy*; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011859:Radiography; D018570:Risk Assessment; D012307:Risk Factors; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000191:economics / Q000209:etiology / Q000628:therapy*; D013125:Spinal Neoplasms / Q000150:complications*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000009:adverse effects / Q000191:economics / Q000592:standards