Current Status of Vertebroplasty for Osteoporotic Compression Fracture

Vertebral compression fracture is the most common complication of osteoporosis. It may result in persistent severe painand limited mobility, and significantly impact the quality oflife. Conservative therapy using external bracing, bed rest andanalgesics is necessary for pain control in these patients.However, some patients may experience protracted or ongoingpain even with these measures. Surgical treatment is indicatedwhen conservative treatment fails, or in patients with spinalinstability or neurologic deficit. Elderly patients often havecomorbilities, and because of osteoporosis, high risk of postoperative complications such as implant loosening, and furtheradjacent fractures. Vertebroplasty involves a percutaneousinjection of bone cement into the collapsed vertebrae underfluroscopic imaging guidance. It was first reported in 1987 forthe management of a painful, aggressive hemangioma of a vertebral body. Since then, vertebroplasty has been widely accepted for the treatment of vertebral osteoporotic compression fractures without neurological damage. This article summarizes the advances in vertebroplasty, and discusses the indications, technique, alternativemethods, results and complications. The contents include a review of the supporting evidence to provide a comparison of the safety and efficacy of vertebroplasty and kyphoplasty.