Minimally invasive treatments of osteoporotic vertebral compression fractures: vertebroplasty and kyphoplasty.

Although nonsurgical treatment of osteoporotic vertebral compression fractures, including medication, exercise, bracing, and bed rest, have been reasonably effective, vertebroplasty and kyphoplasty have evolved as valuable adjunctive treatment options. Over the past decade, vertebroplasty, which involves the percutaneous injection of bone cement directly into the fractured vertebral body, has been used as a treatment for painful osteoporotic vertebral body compression fractures, a leading cause of morbidity in the elderly. Kyphoplasty, another minimally invasive procedure that allows for correction of spinal deformity and for controlled cement filling of the fractured vertebral body, involves the percutaneous cannulation of the vertebral body followed by the placement of an inflatable bone tamp. Reported results for both vertebroplasty and kyphoplasty suggest rapid improvement in pain and physical functioning in patients with osteoporotic vertebral compression fractures. Kyphoplasty allows for low-pressure cement injection and affords the opportunity to correct spinal deformity. Further study is required to define the precise indications, timing, and relative merits of these techniques.