Kyphoplasty for the Treatment of Vertebral Compression Fractures

ABSTRACT

Vertebral compression fractures are the most common fragility fractures, and they have significant medical and economical consequences. Conventional medical therapy for these fractures is aimed at treatment of symptoms with bed rest, analgesic medications, and bracing. Surgery is reserved for those patients with neurological deficits or compression of neural elements. Percutaneous vertebroplasty (PVP) has emerged as a minimally invasive treatment option to strengthen the fractured vertebra and to relieve associated pain. Percutaneous kyphoplasty (PKP) is a novel technique designed to relieve pain, strengthen the fractured vertebra, and restore the height of the compressed vertebra, thus minimizing the spinal deformity and its adverse sequelae. This article provides a brief introduction to this new technique and its current status in clinical practice.

KEYWORDS

Vertebral compression fracture - vertebroplasty - kyphoplasty

REFERENCES

• 1 Cooper C, Atkinson E J, O'Fallon W M, Melton III J L. Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985-1989.  J Bone Miner Res . 1992;  7 221-227
• 2 Heaney R P. The natural history of vertebral osteoporosis. Is low bone mass an epiphenomenon?.  Bone . 1992;  13 S23-S26
• 3 Cohen L D. Fractures of the osteoporotic spine.  Orthop Clin North Am . 1990;  21 143-150
• 4 Rapado A. General management of vertebral fractures.  Bone . 1996;  18 191S-196S
• 5 Mathis J M, Barr J D, Belkoff S M. Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures.  Am J Neuroradiol . 2001;  22 373-381
• 6 Jensen M E, Evans A J, Mathis J M. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects.  Am J Neuroradiol . 1997;  18 1897-1904
• 7 Barr J D, Barr M S, Lemley T J, McCann R M. Percutaneous vertebroplasty for pain relief and spinal stabilization.  Spine . 2000;  25 923-928
• 8 Lyles K W, Gold D T, Shipp K M. Association of osteoporotic vertebral compression fractures with impaired functional status.  Am J Med . 1993;  94 595-601
• 9 Silverman S L. The clinical consequences of vertebral compression fracture.  Bone . 1992;  13 S27-S31
• 10 Schlaich C, Minne H W, Bruckner T. Reduced pulmonary function in patients with spinal osteoporotic fractures.  Osteoporos Int . 1998;  8 261-267
• 11 Leech J A, Dulberg C, Kellie S, Pattee L, Gay J. Relationship of lung function to severity of osteoporosis in women.  Am Rev Respir Dis . 1990;  141 68-71
• 12 Kado D M, Browner W S, Palermo L. Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group.  Arch Intern Med . 1999;  159 1215-1220
• 13 Wong W, Reiley M A, Garfin S. Vertebroplasty/kyphoplasty.  Journal of Women's Imaging . 2000;  2 117-124
• 14 Belkoff S M, Mathis J M, Fenton D C. An ex vivo biomechanical evaluation of an inflatable bone tamp used in the treatment of compression fracture.  Spine . 2001;  26 151-156
• 15 Jensen M E, Dion J E. Percutaneous vertebroplasty in the treatment of osteoporotic compression fractures.  Neuroimaging Clin North Am . 2000;  10 547-568
• 16 Cotten A, Dewatre F, Cortet B. Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up.  Radiology . 1996;  200 525-530
• 17 Mathis J M, Petri M, Naff N. Percutaneous vertebroplasty treatment of steroid-induced osteoporotic compression fractures.  Arthritis Rheum . 1998;  41 171-175
• 18 Belkoff S M, Dremond H, Mathis J M, Jasper L. Vertebroplasty: the biomechanical effect of cement volume (Abst).  Trans Orthop Res Soc . 2000;  25 356
• 19 Tohmeh A G, Mathis J M, Fenton D C, Levine A M, Belkoff S M. Biomechanical efficacy of unipedicular versus bipedicular vertebroplasty for the management of osteoporotic compression fractures.  Spine . 1999;  24 1772-1776
• 20 Lane J M, Girardi F P, Khan S N. Preliminary outcomes of the first 226 consecutive kyphoplasties for the fixation of painful osteoporotic vertebral compression fractures.  J Bone Miner Res . 2000;  15 S198
• 21 Yuan H A, Garfin S R, Lieberman I H, Reiley M A, Yonemura K. Early clinical outcomes with kyphoplasty, the minimally-invasive reduction of painful osteoporotic vertebral body compression fracture. Paper presented at the section on Disorders of the Spine and Peripheral Nerves, 16th Annual Meeting of American Association of Neurological Surgeons and Congress of Neurological Surgeons; February 23-26, 2000; Indian Wells, California