Percutaneous vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures and osteolytic tumours.

©2005 British Editorial Society of Bone and Joint Surgery doi:10.1302/0301-620X.87B12. 16074 $2.00 J Bone Joint Surg [Br] 2005;87-B:1595-604. Back pain is the principal manifestation of most osteoporotic vertebral compression fractures, and may be either acute and excruciating, or chronic and persistent. 1,2 Acute back pain, usually caused by a recent osteoporotic vertebral compression fracture, is expected to subside as the fracture heals, over a period of approximately three months. 3 However, it is estimated that one-third 4 to three-quarters 5 of such patients may then develop chronic back pain. The causes may be attributed to pseudarthrosis or to osteoporotic spinal deformity such as kyphosis or kyphoscoliosis engendering a kaleidoscope of problems. The degree of kyphosis correlates well with the patient’s physical function, the risk of further fractures, 6,7 compression of the spinal cord, mental well-being and pulmonary function, 8 any of which may contribute to an increased mortality rate. 7,9,10 Conservative treatment cannot address the deformity. Major reconstructive surgery is indicated for crippling deformity and for neurocompression. 11