Abstract
Percutaneous vertebral augmentation/consolidation techniques are varied. These are
vertebroplasty, kyphoplasty, and several methods with percutaneous introduction of
an implant (associated or not with cement injection). They are proposed in painful
osteoporotic vertebral fractures and traumatic fractures. The objectives are to consolidate
the fracture and, if possible, to restore the height of the vertebral body to reduce
vertebral and regional kyphosis. Stabilization of the fracture leads to a reduction
in pain and thus restores the spinal support function as quickly as possible, which
is particularly important in the elderly. The effectiveness of these interventions
on fracture pain was challenged once by two randomized trials comparing vertebroplasty
to a sham intervention. Since then, many other randomized studies in support of vertebroplasty
efficacy have been published. International recommendations reserve vertebroplasty
for medical treatment failures on pain, but earlier positioning may be debatable if
the objective is to limit kyphotic deformity or even reexpand the vertebral body.
Recent data suggest that in osteoporotic fracture, the degree of kyphosis reduction
achieved by kyphoplasty and percutaneous implant techniques, compared with vertebroplasty,
is not sufficient to justify the additional cost and the use of a somewhat longer
and traumatic procedure. In young patients with acute traumatic fractures and a significant
kyphotic angle, kyphoplasty and percutaneous implant techniques are preferred to vertebroplasty,
as in these cases a deformity reduction has a significant positive impact on the clinical
outcome.
Keywords
vertebral fracture - vertebroplasty - kyphoplasty - vertebral augmentation techniques
- interventional radiology
