Vertebroplasty and kyphoplasty useful in short term, review finds

Aug 9 2011
The International Osteoporosis Foundation Fracture Working Group recently reviewed studies on two minimally invasive spine surgeries, vertebroplasty (VP) and balloon kyphoplasty (BKP), which are used to strengthen the spine after vertebral fractures.

The review found the procedures rarely caused serious complications, and tended to relieve back pain faster than conservative treatment options did. They generally stabilize the fracture, preventing vertebral collapse, and may restore vertebral height. The procedures don't directly relieve back pain, but mechanically repairing the vertebra generally prevents further injury and restores a healthier shape to the spine, relieving the pressure a fractured vertebra places on the rest of the back.

"Referring physicians should be aware that VP and BKP are available options for the management of vertebral compression fractures, with possible clinical benefits to their patients in terms of acute pain relief and improved quality of life," said Kristina Åkesson, chair of the working group.

However, she also said that more long-term research is needed to determine the chance of additional fractures in patients who had VP or BKP procedures, and noted that osteoporosis should be managed appropriately to minimize the risk of further fractures.

Osteoporosis commonly contributes to vertebral fractures by weakening bones, although they can be caused by traumas such as certain sports injuries. The procedures involve injecting a cement-like substance into the fractured vertebra. This substance hardens quickly, stabilizing the vertebra and strengthening the spine. Kyphoplasty uses a balloon to create a cavity within the fractured vertebra first, while vertebroplasty uses existing space.

A single vertebral fracture can increase the pressure on the rest of the spine, making additional fractures more likely, and may lead to conditions and complications such as spinal deformity, reduced mobility or impaired movement.

Fractured vertebra are also associated with back pain, disability and kyphosis, in which the back becomes stooped. Usually performed as out-patient procedures, vertebroplasty and kyphoplasty are generally recommended when conservative treatments are ineffective or in cases when medications may cause problematic side effects.

According to Radiology Info, a website maintained by the American College of Radiology and the Radiological Society of North America, the procedures may also be recommended in young patients with metabolic disorder or a history of steroid treatment, or in elderly patients whose bones or body are too weak for surgical repair or open spinal surgery.