Bone augmentation: past, present, and future

Painful skeletal and vertebral conditions caused by degeneration, fractures, infection, and neoplasm are common and associated with high morbidity and mortality. Since the introduction of modern orthopedic surgery these conditions have been treated with a multitude of techniques. Bone augmentation and grafting have emerged as integral parts of orthopedic reconstructive, reparative, and palliative surgery. As imaging-guided therapy has developed, image-guided procedures to achieve bone augmentation have also emerged. It is important for the radiologist to understand the materials and methods used to achieve bone augmentation. A variety of materials are available for the application of hone augmentation. Methods used to accomplish bone augmentation often are performed under image guidance. Applications in the axial skeleton include vertebroplasty, kyphoplasty (balloon-assisted vertebroplasty), sacroplasty, and acetabuloplasty. This article discusses the development, current trends, and possible future directions of bone augmentation.