Vertebroplasty and kyphoplasty:  new evidence adds heat to the debate.
OBJECTIVE
Cement bone augmentation has become very popular worldwide in treating painful noncomplicated spine fractures. Controversy about the effectiveness was raised by two randomized trials in 2009. Recent new evidence contradicts those findings giving credit to vertebroplasty/kyphoplasty.


RESULTS
Well designed prospective clinical trials in cancer and noncancer vertebral fractures as well as an excellent meta-analysis showed that painful vertebral compression fractures have better and faster pain relief, better functional outcomes, and with low complication rate when treated with percutaneous cement than conservatively.


CONCLUSIONS
The saga is unfinished. The treatment of vertebral compression fractures with cement augmentation is still in its infancy. The potential for development with new materials and the injection of biologic and active bone cements or anticancer products, in metastatic disease, will revolutionize the treatment of this condition.
Department of Anesthesia and Alan Edwards McGill Pain Center, McGill University Health Center, Montreal Quebec, Canada. jfasenjog@gmail.com
Juan-Francisco
JF
Asenjo
Felipe
F
Rossel
D000758:Anesthesia; D001843:Bone Cements; D000075202:Contraindications; D003362:Cost-Benefit Analysis; D006801:Humans; D058498:Kyphoplasty / Q000009:adverse effects / Q000379:methods*; D009369:Neoplasms / Q000150:complications; D010024:Osteoporosis / Q000150:complications; D016032:Randomized Controlled Trials as Topic; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000009:adverse effects / Q000379:methods*
D001843:Bone Cements