Abstract
Osteoporotic vertebral compression fractures frequently result in significant morbidity and health care resource use. For patients with severe and disabling pain, vertebral augmentation (vertebroplasty and kyphoplasty) is often considered. Although vertebroplasty was introduced >30 years ago, there are conflicting opinions regarding the role of these procedures in the treatment of osteoporotic vertebral compression fractures. This review article updates clinicians on the published prospective randomized controlled data, including the most recent positive trials that followed initial negative trials in 2009. Analysis of multiple national claim datasets has also provided further insight into the utility of these procedures. Finally, we considered the recent recommendations of national organizations and medical societies that advise on the use of vertebral augmentation procedures for osteoporotic vertebral compression fractures.
Highlights
In the Taiwanese dataset that identified 10,785 elderly patients hospitalized with a painful vertebral compression fractures (VCFs), the risk of death was 39% higher in patients receiving medical management compared with vertebroplasty
The Investigational Vertebroplasty Safety and Efficacy Trial (INVEST) and trials of Buchbinder et al[23,24] had been published, and public funding for vertebroplasty in Australia was removed in 2011.68 In contrast, the National Institute for Health and Care Excellence, which provides evidence-based guidance and advice to the National Health Service in the United Kingdom examined the evidence to November 2011.69 In April 2013, the National Institute for Health and Care Excellence recommended vertebroplasty and kyphoplasty as treatment options for patients with severe pain after a recent osteoporotic VCF and concluded that it was reasonable to assume that vertebroplasty and kyphoplasty reduce mortality.[70]
The evidence for vertebroplasty in the treatment of osteoporotic fractures has evolved with time
Summary
The VERTOS II study followed, another large prospective multicenter RCT designed to compare early vertebroplasty with medical management.[27] Inclusion criteria were 50 years of age or older, moderate back pain (VAS Ն 5), fracture age (Ͻ6 weeks), focal tenderness, and MR imaging bone edema.[28] Two hundred two patients were enrolled (n ϭ 101 for vertebroplasty, n ϭ 101 for medical management).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
