Vertebroplasty and Kyphoplasty

  • Nicole S. Carter
  • Hong Kuan Kok
  • Julian Maingard
  • Hamed Asadi
  • Vinil Shah
  • Thabele Leslie-Mazwi
  • Joshua A. Hirsch
  • Ronil V. Chandra


Vertebral compression fractures (VCFs) are a common complication of osteoporosis. They are variably symptomatic, and many can be well managed with conservative treatments such as analgesia, orthotic bracing or bed rest. However, in a subset population of patients, back pain will persist despite a trial of conservative management or will be severe enough to require high doses of narcotic analgesia or hospitalization. In these patients, vertebral augmentation procedures appear to provide substantial benefit. Augmentation may also be performed for patients with painful VCFs due to spinal metastases or primary spinal neoplasms. Vertebral augmentation procedures, encompassing vertebroplasty and kyphoplasty, involve the percutaneous, image-guided infiltration of cement into the fractured vertebra. In vertebroplasty, cement is injected directly into the vertebral body, while balloon kyphoplasty includes a further step in which a tamp is inflated to create a bony cavity for cement injection. The goals of these procedures are the relief of back pain, enhancement of functional status and mobility and biomechanical stabilization of the vertebral body. Despite mixed results from early trials of vertebral augmentation, after positive results from recent large randomized studies, there is high-quality evidence to support the use of these procedures in acute VCFs refractory to conservative therapy. Vertebroplasty and kyphoplasty are safe procedures, with low rates of serious complications. This chapter will outline a practical guide to the patient selection, pre-procedural planning, procedural technique and after-care of vertebroplasty and kyphoplasty. The latest evidence for the efficacy and safety of these procedures is presented and reviewed.


Vertebral augmentation Vertebroplasty Kyphoplasty Vertebral compression fracture Osteoporosis Metastasis Pain 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Nicole S. Carter
    • 1
  • Hong Kuan Kok
    • 2
  • Julian Maingard
    • 3
    • 4
  • Hamed Asadi
    • 5
  • Vinil Shah
    • 6
  • Thabele Leslie-Mazwi
    • 7
  • Joshua A. Hirsch
    • 8
  • Ronil V. Chandra
    • 9
  1. 1.Monash Health, Interventional Neuroradiology Unit, Monash ImagingClaytonAustralia
  2. 2.Department of RadiologyNorthern HospitalMelbourneAustralia
  3. 3.Interventional Neuroradiology Service, Department of RadiologyAustin HospitalMelbourneAustralia
  4. 4.Interventional Neuroradiology Unit, Monash Imaging, Monash HealthMelbourneAustralia
  5. 5.Department of RadiologyAustin HealthHeidelbergAustralia
  6. 6.Radiology and Biomedical Imaging, Neuroradiology SectionUniversity of California, San FranciscoSan FranciscoUSA
  7. 7.Departments of Neurosurgery and Neurology, Neuroendovascular Program and Neurocritical CareMassachusetts General HospitalBostonUSA
  8. 8.Department of RadiologyMassachusetts General HospitalBostonUSA
  9. 9.Department of Medicine, Surgery and Imaging, Monash Medical Centre, Diagnostic and Interventional Neuroradiology, Monash Imaging-Monash HealthMonash UniversityClaytonAustralia

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