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Percutaneous cement augmentation for osteoporotic vertebral fractures
Amer Sebaaly1, Maroun Rizkallah1, Falah Bachour1
1Department of Orthopedic Surgery, Bellevue Medical Center University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
EFORT Open Reviews
|July 25, 2017
Summary
Osteoporotic vertebral fractures are common, affecting one-fifth of the osteoporotic population. Cement augmentation techniques like vertebroplasty and kyphoplasty offer superior treatment for symptomatic fractures compared to medical management.
Area of Science:
- Orthopedics
- Radiology
- Geriatrics
Background:
- Thoracolumbar vertebral fractures are common in both young (high-velocity trauma) and older (minor trauma/spontaneous) populations.
- Osteoporotic vertebral fractures represent the most prevalent type of osteoporotic fracture, impacting approximately 20% of individuals with osteoporosis.
- Percutaneous fixation via vertebroplasty presents a minimally invasive alternative to open surgical repair for these fractures.
Purpose of the Study:
- To review current cement augmentation techniques for thoracolumbar vertebral fractures.
- To highlight critical factors for successful percutaneous augmentation.
- To propose a treatment algorithm for selecting appropriate patients for these procedures.
Main Methods:
- Review of existing literature on vertebroplasty, kyphoplasty, and stentoplasty.
- Analysis of comparative studies evaluating cement augmentation versus optimal medical treatment.
- Development of a treatment algorithm based on fracture characteristics and patient factors.
Main Results:
- Despite initial concerns, cement augmentation has demonstrated superiority over optimal medical treatment for symptomatic osteoporotic vertebral fractures.
- Kyphoplasty offers advantages over vertebroplasty, including improved kyphosis reduction and decreased cement leakage.
- Newer techniques like stentoplasty are emerging with promising outcomes.
Conclusions:
- Percutaneous cement augmentation is an effective treatment for selected thoracolumbar osteoporotic vertebral fractures.
- Careful patient selection and evaluation are crucial for optimizing outcomes.
- A structured treatment algorithm can guide the selection of patients who will benefit most from these minimally invasive procedures.
