Treatment of Osteoporotic Spine Fractures Using Cement Augmentation: A Mini Review
Vertebral body compression fractures due to osteoporosis
is the most common fracture in patients with osteoporosis.
It affects significantly the quality of life and is associated with
pain interfering with activities of daily living.
The management of osteoporotic vertebral body
fracture could be surgical or non-surgical.
Medical treatment is focused on better mineralization
of bone to stop osteoporosis or to improve the quality of bone.
Any underlying metabolic abnormalities and provision
of supplemental calcium/vitamin D in conjunction with
bisphosphonates or calcitonin, or both.
Routine hormone replacement therapy has fallen out of favor
because of concerns regarding adverse effects identified in long-term follow-up studies.
In many cases, the vertebral body fracture is significant
and requires surgical intervention.
This article will focus on cement augmentation options.
Vertebral body augmentation utilizing poly(methyl methacrylate) cement injected
into the involved vertebral body.
This can be done by 2 main techniques: vertebroplasty, or kyphoplasty.
Vertebroplasty was first introduced and kyphoplasty was introduced later to overcome
the complications with mainly cement extravasation and to better restore the vertebral body
height.
Although there are several studies supporting both procedures,
there were few studies that were questioning the outcome.
Two studies that created lots of discussion among the medical community
are the papers by Kallmes et al and Buchbinder et al3 they found vertebroplasty
and sham vertebroplasty to be equally effective in reducing pain and improving function.
But, this was criticized due to the relatively small number of cases and the numerous number
of studies with the opposite conclusions. The general consensus is that cement augmentation is
one of the acceptable treatment options in pathologic fractures including osteoporosis.
Orthop Res Traumatol Open J. 2016; 2(1): 1-5. doi: 10.17140/ORTOJ-2-106
