Osteoporotic Vertebral Fractures and the Role of Percutaneous Vertebroplasty in Patient Care

  • Yat Wing Smart
Keywords: Osteoporosis, Vertebroplasty

Abstract


Background: Osteoporosis is an age-related skeletal condition of bone, with increasing prevalence in older populations. Insufficiency of the bone is associated with increased disability and mortality. Vertebral fractures are commonly secondary to osteoporosis, however only a proportion of patients may present clinically with identifiable symptoms. Percutaneous vertebroplasty is an interventional method of managing such patients.
Aim: To determine the role of percutaneous vertebroplasty in managing patients with osteoporotic vertebral fractures.


Methods: Electronic databases including MEDLINE, Cochrane Library and NHS Evidence were searched for meta-analyses and randomised controlled trials, with some provision given to expert reviews due to the small pool of publications available. Search terms used included “osteoporosis and vertebral fractures”, “vertebroplasty and osteoporosis”, “percutaneous vertebroplasty in the management of osteoporosis”, “vertebral body cement augmentation”, and “balloon kyphoplasty”. 

Results: Vertebroplasty reduces pain in the short-term (up to 2 weeks) after surgery and has sustained effects in improving quality of life. The long-term effects are difficult to establish due to the underlying osteoporosis disease progression and comorbidities.


Conclusion: Vertebroplasty is worthwhile in treating acute vertebral fractures associated with pain. However more research is needed to fully determine its effectiveness in the long term.

References

References
1 International Osteoporosis Foundation. Facts and Statistics. Available at Accessed 09 December 2014.
2 Kumar P and Clark M. Kumar & Clark’s Clinical Medicine. 8th Edition. Edinburgh: Saunders Elsevier: 2012. p.552.
3 NICE. Osteoporosis: fragility fracture risk. 2012. Available at
4 National Osteoporosis Society. Key Facts & Figures. Available at Accessed 09 December 2014.
5 Santiago F R, Chinchilla A S, Alvarez L G et al. Comparative review of vertebroplasty and kyphoplasty. World Journal of Radiology. 2014; 6(6): 329-343.
6 Gerdhem P. Osteoporosis and fragility fractures: Vertebral fractures. Best Practice & Research Clinical Rheumatology. 2013; 27: 743-755.
7 Francis R M, Baillie S P, Chuck A J et al. Acute and long-term management of patients with vertebral fractures. The International Journal of Medicine. 2004; 97: 63-74.
8 NICE. Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for treating osteoporotic vertebral compression fractures. 2013. Available at
9 Genant H K, Wu C Y, van Kuijk C et al. Vertebral fracture assessment using a semiquantitative technique. Journal of Bone and Mineral Research. 1993; 8: 1137-1148.
10 Lenchik L, Rogers L F, Delmas P D et al. Diagnosis of Osteoporotic Vertebral Fractures: Importance of Recognition and Description by Radiologists. American Journal of Roentgenology. 2004; 183(4)
11 Alexandru D, So W. Evaulation and Management of Vertebral Compression Fractures. The Permanente Journal. 2012; 16(4): 46-51.
12 Nairn R J, Binkhamis S, Sheikh A. Current Perspectives on Percutaneous Vertebroplasty: Current Evidence/Controversies, Patient Selection and Assessment, and Technique and Complications. Radiology Research and Practice. 2011; 1-10.
13 Farrokhi M R, Alibai E, Maghami Z. Randomized controlled trial of percutanaeous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures. Journal of Neurosurgery: Spine. 2011; 14: 561-569.
14 Rousing R. Andersen M O, Jespersen S M et al. Percutaneous vertebroplasty compared to conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures: three-months follow-up in a clinical randomized study. Spine (Phila Pa 1976). 2009; 34(13): 1349-1354.
15 Buchbinder K, Osbourne R H, Ebeling P R et al. A Randomized Trial of Vertebroplasty for Painful Osteoporotic Vertebral Fractures. The New England Journal of Medicine. 2009; 361(6): 557-568.
16 Kallmes D F, Comstock B A, Heagerty P J et al. A Randomized Controlled Trial of Vertebroplasty for Osteoporotic Spine Fractures. The New England Journal of Medicine. 2009; 361(6): 569-579.
17 Klazen C, Lohle P, de Vries J et al. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (VERTOS II): an open-label randomised trials. The Lancet. 2010; 376: 1085-1092
18 Chen L, Lai P, Chen W. Current Status of Vertebroplasty for Osteoporotic Compression Fracture. Chang Gung Medical Journal. 2011;34: 352-359.
19 Medical Advisory Secreteriat. Percutaneous Vertebroplasty for Treatment of Painful Osteoporotic Vertebral Compression Fractures: An Evidence-Based Analysis. Ontario Health Technology Assessment Series. 2010; 10(19): 1-45.
20 University of Sheffield. WHO Fracture Risk Assessment Tool. Available at Accessed 13 December 2014.
21 Radiological Society of North America. Osteoporosis. Available at Accessed 13 December 2014.
22 Klazen C, Venmans A, De Vries J et al. Percutaneous vertebroplasty is not a risk factor for new osteoporotic compression fractures: results from VERTOS II. American Journal of Neuroradiology. 2010; 31(8): 1447-1450.
Published
21-Dec-2015
How to Cite
Smart, Y. W. (2015). Osteoporotic Vertebral Fractures and the Role of Percutaneous Vertebroplasty in Patient Care. Res Medica, 23(1), 22-28. https://doi.org/10.2218/resmedica.v23i1.1238
Section
Clinical Review Article