Vertebroplasty and Kyphoplasty: a Comprehensive Review
Vertebroplasty and kyphoplasty are relatively new techniques used to treat painful vertebral compression fractures (VCFs). Vertebroplasty is the injection of bone cement, generally polymethyl methacrylate (PMMA), into a vertebral body (VB). Kyphoplasty is the placement of balloons (called "tamps") into the VB, followed by an inflation/deflation sequence to create a cavity prior to the cement injection. These procedures are most often performed in a percutaneous fashion on an outpatient (or short stay) basis. The mechanism of action is unknown, but it is postulated that stabilization of the fracture leads to analgesia. The procedures are indicated for painful VCFs due to osteoporosis or malignancy, and for painful hemangiomas. These procedures may be efficacious in treating painful vertebral metastasis and traumatic VCFs. Much evidence favors the use of these procedures for pain associated with the aforementioned disorders. The risks associated with the procedures are low but serious complications can occur. These risks include spinal cord compression, nerve root compression, venous embolism, and pulmonary embolism including cardiovascular collapse. The risk/benefit ratio appears to be favorable in carefully selected patients. The technical aspects of the procedures are presented in detail along with guidelines for patient selection. A comprehensive review of the evidence for the procedures and the reported complications is presented.
Vertebroplasty and kyphoplasty are relatively new techniques that are being used to treat painful VCFs. Vertebroplasty is the percutaneous injection of a VB with bone cement (generally PMMA, which has been used in orthopedic procedures since the late 1960s). Use of PV for the treatment of painful hemangiomas was first reported by a group of French researchers in 1987. Over the next 15 years, a variety of groups have advocated expanding the indications for PV to include osteoporotic compression fractures, traumatic compression fractures, and painful vertebral metastasis.
Kyphoplasty is a modification of PV. It involves the percutaneous placement of balloons (called "tamps") into the VB, followed by an inflation/deflation sequence to create a cavity prior to the cement injection. The PK procedure may restore VB height and reduce the kyphotic angulation of the compression fracture prior to PMMA injection. The technical aspects of the procedures are presented in detail, along with patient selection criteria. A comprehensive review of the evidence supporting use of these procedures and their reported complications is presented.
Vertebroplasty and kyphoplasty are relatively new techniques used to treat painful vertebral compression fractures (VCFs). Vertebroplasty is the injection of bone cement, generally polymethyl methacrylate (PMMA), into a vertebral body (VB). Kyphoplasty is the placement of balloons (called "tamps") into the VB, followed by an inflation/deflation sequence to create a cavity prior to the cement injection. These procedures are most often performed in a percutaneous fashion on an outpatient (or short stay) basis. The mechanism of action is unknown, but it is postulated that stabilization of the fracture leads to analgesia. The procedures are indicated for painful VCFs due to osteoporosis or malignancy, and for painful hemangiomas. These procedures may be efficacious in treating painful vertebral metastasis and traumatic VCFs. Much evidence favors the use of these procedures for pain associated with the aforementioned disorders. The risks associated with the procedures are low but serious complications can occur. These risks include spinal cord compression, nerve root compression, venous embolism, and pulmonary embolism including cardiovascular collapse. The risk/benefit ratio appears to be favorable in carefully selected patients. The technical aspects of the procedures are presented in detail along with guidelines for patient selection. A comprehensive review of the evidence for the procedures and the reported complications is presented.
Vertebroplasty and kyphoplasty are relatively new techniques that are being used to treat painful VCFs. Vertebroplasty is the percutaneous injection of a VB with bone cement (generally PMMA, which has been used in orthopedic procedures since the late 1960s). Use of PV for the treatment of painful hemangiomas was first reported by a group of French researchers in 1987. Over the next 15 years, a variety of groups have advocated expanding the indications for PV to include osteoporotic compression fractures, traumatic compression fractures, and painful vertebral metastasis.
Kyphoplasty is a modification of PV. It involves the percutaneous placement of balloons (called "tamps") into the VB, followed by an inflation/deflation sequence to create a cavity prior to the cement injection. The PK procedure may restore VB height and reduce the kyphotic angulation of the compression fracture prior to PMMA injection. The technical aspects of the procedures are presented in detail, along with patient selection criteria. A comprehensive review of the evidence supporting use of these procedures and their reported complications is presented.
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