Osteoporotic vertebral
compression fractures (OVF) are an increasing public health problem. Cement augmentation (
vertebroplasty of
kyphoplasty) helps stabilize painful OVF refractory to medical treatment. This stabilization is thought to improve
pain and functional outcome.
Vertebroplasty consists of injecting cement into a fractured vertebra using a percutaneous transpedicular approach. Balloon
kyphoplasty uses an inflatable balloon prior to injecting the cement. Although
kyphoplasty is associated with significant improvement of local
kyphosis and less cement leakage, this does not result in long-term clinical and functional improvement. Moreover,
vertebroplasty is favored by some due to the high cost of
kyphoplasty. The injection of cement increases the stiffness of the fracture vertebrae. This can lead, in theory, to adjacent OVF. However, many studies found no increase of subsequent fracture when comparing medical treatment to cement augmentation.
Kyphoplasty can have a protective effect due to restoration of sagittal balance.