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Vertebroplasty and kyphoplasty 

Vertebroplasty and kyphoplasty
Chapter:
Vertebroplasty and kyphoplasty
Author(s):

Jules Comin

and David A. Connell

DOI:
10.1093/med/9780198713340.003.0012
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date: 05 August 2020

Vertebral compression fractures (VCFs) are common in osteoporotic patients and are a significant cause of pain and consequent disability, morbidity, and mortality.

The mechanism of pain in osteoporotic compression fractures is poorly understood but probably relates to instability and oedema of the fractured bone.

Conservative management measures are unsuccessful in approximately 10% of patients, and many patients will develop chronic deformity and consequent disability.

MRI or radioisotope bone scans are useful for identifying symptomatic fractured vertebral bodies.

Vertebroplasty is probably most effective in reducing pain and preventing deformity when performed in patients with symptoms of less than 2–3 months duration.

Kyphoplasty has the added advantage of constraining the flow of cement (methyl methacrylate) to the confines of the vertebral body but is more technically demanding and more expensive. Controversy exists as to whether this technique results in any clinically significant restoration in vertebral height.

Sacroplasty should be considered for symptomatic insufficiency fractures of the sacrum.

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