Spinal augmentation

Refers to vertebroplasty or kyphoplasty.

Vertebroplasty involves cement being injected under pressure into the fractured vertebrae.

Kyphoplasty involves injection of cement into a cavity created by the inflation of a balloon placed within the fractured vertebral body..

Minimally invasive treatments for symptomatic relief following osteoporotic vertebral compression fractures.

Both procedures involve percutaneous injection of bone cement into the collapsed vertebral body.

Studies comparing vertebroplasty and kyphoplasty with conservative, nonsurgical therapy reveals significant reduction in pain, analgesic use and disability spinal augmentation at one month and one year.

However, double blinded controlled studies failed to demonstrate improvements in pain and disability with vertebroplasty, suggesting benefits of spinal augmentation may reflect placebo effect.

Vertebral augmentation with the use of percutaneous injected cement into one more fractures renders fractures immobile and attempts to restore biomechanical integrity.

Complications of extravasation of cement and other complications can occur, sometimes leading to fatal results.

Most vertebroplasties are performed by radiologists, and most kyphoplasty procedures performed by non radiologists such as orthopedists.

In 2010 almost 25,000 vertebroplasties were performed, and 48 thousand kyphoplasties were performed

Evidence supporting spinal augmentation to improve symptomatic outcome after an acute osteoporotic vertebral fracture is mixed.

Sham-blinded controlled studies show no significant benefit on self-reported pain or function after one month of follow-up.

Randomized studies comparing kyphoplasty to conservative therapy found treatment improved pain and function at six and 17 months, but by 24 months the differences were not significant (Boonen S et al ).

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