Trends in Vertebral Augmentation Practice for Osteoporotic Vertebral Fracture

Abstract

Osteoporosis is characterized by low bone mass, primarily affecting older individuals and a common complication is vertebral fractures. The collapse-induced height loss in vertebrae can result in spinal instability and progressive kyphotic deformity. Surgical intervention for osteoporotic vertebrae poses challenges due to poor bone quality and frequent medical comorbidities. In recent years, it has become the predominant method for vertebral augmentation in acute fractures, aiming to relieve pain, strengthen the vertebral structure, and prevent deformities by restoring height. These procedures involve percutaneous placement of cannulas into each collapsed vertebral body through a unipedicular or bipedicular approach.
 Novel products are emerging to strengthen vertebrae in treating osteoporotic compression fractures. Balloon kyphoplasty and vertebroplasty are widely accepted and recognized as effective vertebral augmentation methods. Treatment guidelines are evolving with the introduction of innovative systems like Vertebral Body Stenting, Titanium Mesh, and Sky Bone Expander, claiming to achieve exceptional vertebral height restoration. Controversies persist regarding the optimal timing for vertebral augmentation post-fracture.
 Polymethylmethacrylate cement is extensively used to stabilize fractured vertebral bodies. Additionally, new calcium phosphate-based nanocomposite cements are gaining prominence. These advancements underscore the ongoing development in the treatment of osteoporotic vertebral compression fractures. Each innovative implant introduces unique features and indications. Precise confirmation of the source of the painful fracture is crucial for effective and safe treatment, ensuring proper timing and indication.