Skip to main content
SpringerLink
Log in

Kyphoplasty - the Current Treatment for Osteoporotic Vertebral Fractures

  • Reference work entry
  • First Online:
Book cover European Surgical Orthopaedics and Traumatology

  • 274 Accesses

Abstract

Vertebral osteoporotic fractures are the most frequent fractures in older patients with low mineral bone density. Kyphoplasty is a technique that tries to recover the height of the fractured vertebral body and support this fracture with the injection of cement into the vertebral body. This procedure is usually performed percutaneously and requires appropriate training so as to avoid potential complications. This chapter reviews the indications, pre-operative preparation and planning, operative technique guidelines, post-operative care and rehabilitation and the complications that might appear during and after this procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 649.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 949.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Lin JT, Lane JM. Osteoporosis: a review. Clin Orthop Relat Res. 2004;425:126–34.

    Article  PubMed  Google Scholar 

  2. Rao RJ, Manoj MD. Current concepts review. Painful osteoporotic vertebral fracture pathogenesis, evaluation and roles of vertebroplasty and kiphoplasty in its management. J Bone Joint Surg Am. 2003;85-A:10.

    Google Scholar 

  3. Hiwatashi A, Moritani T, Numaguchi Y, et al. Increase in vertebral body height after vertebroplasty. AJNR Am J Neuroradiol. 2003;24:185–9.

    PubMed  Google Scholar 

  4. Teng MM, Wei CJ, Wei LC, et al. Kyphosis correction and height restoration effects of percutaneous vertebroplasty. AJNR Am J Neuroradiol. 2003;24:1893–900.

    PubMed  Google Scholar 

  5. Carlier RY, Gordji H, Mompoint DM, et al. Osteoporotic vertebral collapse: percutaneous vertebroplasty and local kyphosis correction. Radiology. 2004;233:891–8.

    Article  PubMed  Google Scholar 

  6. Dublin AB, Hartman J, Latchaw RE, et al. The vertebral body fracture in osteoporosis: restoration of height using percutaneous vertebroplasty. AJNR Am J Neuroradiol. 2005;26:489–92.

    PubMed  Google Scholar 

  7. Rhyne 3rd A, Banit D, Laxer E, et al. Kyphoplasty: report of eighty-two thoracolumbar osteoporotic vertebral fractures. J Orthop Trauma. 2004;18:294–9.

    Article  PubMed  Google Scholar 

  8. Majd ME, Farley S, Holt RT. Preliminary outcomes and efficacy of the first 360 consecutive kyphoplasties for the treatment of painful osteoporotic vertebral compression fractures. Spine J. 2005;5:244–55.

    Article  PubMed  Google Scholar 

  9. Voggenreiter G. Balloon kyphoplasty is effective in deformity correction of osteoporotic vertebral compression fractures. Spine. 2005;30:2806–12.

    Article  PubMed  Google Scholar 

  10. Pradhan BB, Bae HW, Kropf MA, et al. Kyphoplasty reduction of osteoporotic vertebral compression fractures: correction of local kyphosis versus overall sagittal alignment. Spine. 2006;31:435–41.

    Article  PubMed  Google Scholar 

  11. Shindle MK, Gardner MJ, Koob J, et al. Vertebral height restoration in osteoporotic compression fractures: kyphoplasty balloon tamp is superior to postural correction alone. Osteoporos Int. 2006;17:1815–9.

    Article  CAS  PubMed  Google Scholar 

  12. Grohs JG, Matzner M, Trieb K, et al. Minimal invasive stabilization of osteoporotic vertebral fractures: a prospective nonrandomized comparison of vertebroplasty and balloon kyphoplasty. J Spinal Disord Tech. 2005;18:238–42.

    PubMed  Google Scholar 

  13. Belkoff SM, Maroney M, Fenton DC, et al. An in vitro biomechanical evaluation of bone cements used in percutaneous vertebroplasty. Bone. 1999;25(2 Suppl):23S–6.

    Article  CAS  PubMed  Google Scholar 

  14. Jensen ME, Evans AJ, Mathis JM, et al. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol. 1997;18:1897–904.

    CAS  PubMed  Google Scholar 

  15. Armsen N, Boszczyk B. Vertebro-/kyphoplasty: history, development, results. Eur J Trauma. 2005;31:433–41.

    Article  Google Scholar 

  16. Berlemann U, Franz T, Orler R, Heini PF. Kyphoplasty for treatment of osteoporotic vertebral fractures: a prospective non-randomized study. Eur Spine J. 2004;13:496–501.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Garfin SR, Yuan HA, Reiley MA. New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine. 2001;26:1511–5.

    Article  CAS  PubMed  Google Scholar 

  18. Cortet B, Cotten A, Boutry N, et al. Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study. J Rheumatol. 1999;26:2222–8.

    CAS  PubMed  Google Scholar 

  19. Heini PF, Wälchli B, Berlemann U. Percutaneous transpedicular vertebroplasty with PMMA – a prospective study for the treatment of osteoporotic compression fractures. Eur Spine J. 2000;9:445–50.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Heini PF, Orler R. Kyphoplasty for treatment of osteoporotic vertebral fractures. Eur Spine J. 2004;13:184–92.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Lieberman I, Reinhardt MK. Vertebroplasty and kyphoplasty for osteolytic vertebral collapse. Clin Orthop Relat Res. 2003;415S:S176–86.

    Article  Google Scholar 

  22. Lane JM, Hong R, Koob J, et al. Kyphoplasty enhances function and structural alignment in multiple myeloma. Clin Orthop. 2004;426:49–53.

    Article  PubMed  Google Scholar 

  23. Pflugmacher R, Taylor R, Agarwal A, et al. Balloon kyphoplasty in the treatment of metastatic disease of the spine: a 2-year prospective evaluation. Eur Spine J. 2008;17:1042–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Hadjipavlou A, Tosounidis T, Gaitanis I, et al. Balloon kyphoplasty as a single or as an adjunct procedure for the management of symptomatic vertebral haemangiomas. J Bone Joint Surg Br. 2007;89(4):495–502.

    Article  CAS  PubMed  Google Scholar 

  25. Jang JS, Kim DY, Lee SO. Efficacy of percutaneous vertebroplasty in the treatment of intravertebral pseudarthrosis associated with noninfected avascular necrosis of the vertebral body. Spine. 2003;28(14):1588–92.

    PubMed  Google Scholar 

  26. McGraw JK, Cardella J, Barr JD, et al. Society of interventional radiology quality improvement guidelines for percutaneous vertebroplasty. J Vasc Interv Radiol. 2003;14:S311–5.

    Article  PubMed  Google Scholar 

  27. Hauck S, Beisse R, Bühren V. Vertebroplasty and kyphoplasty in spinal trauma. Eur J Trauma. 2005;31:453–63.

    Article  Google Scholar 

  28. Oner FC, Verlaan JJ, Verbout AJ, Dhert WJ. Cement augmentation techniques in traumatic thoracolumbar spine fractures. Spine. 2006;31(11):S89–95.

    Article  PubMed  Google Scholar 

  29. Verlaan JJ, Dhert WJ, Verbout AJ, et al. Balloon vertebroplasty in combination with pedicle screw instrumentation: a novel technique to treat thoracic and lumbar burst fractures. Spine. 2005;30:E73–9.

    Article  PubMed  Google Scholar 

  30. Verlaan JJ, van de Kraats EB, Oner FC, et al. The reduction of endplate fractures during balloon vertebroplasty. A detailed radiological analysis of the treatment of burst fractures using pedicle screws, balloon vertebroplasty, and calcium phosphate cement. Spine. 2005;30(16):1840–5.

    Article  PubMed  Google Scholar 

  31. Pflugmacher R, Agarwal A, Kandziora F, Klostermann C. Balloon kyphoplasty combined with posterior instrumentation for the treatment of burst fractures of the spine – 1-year results. J Orthop Trauma. 2009;23(2):126–31.

    Article  PubMed  Google Scholar 

  32. Korovessis P, Repantis T, Petsinis G, et al. Direct reduction of thoracolumbar burst fractures by means of balloon kyphoplasty with calcium phosphate and stabilization with pedicle-screw instrumentation and fusion. Spine. 2008;33(4):E100–8.

    Article  PubMed  Google Scholar 

  33. Lieberman IH, Dudeney S, Reinhardt MK, et al. Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine. 2001;26:1631–8.

    Article  CAS  PubMed  Google Scholar 

  34. Mathis JM. Percutaneous vertebroplasty or kyphoplasty: which one do I choose? Skeletal Radiol. 2006;35:629–31.

    Article  PubMed  Google Scholar 

  35. Boszczyk BM, Bierschneider M, Schmid K, et al. Microsurgical interlaminary vertebroplasty and kyphoplasty for severe osteoporotic fractures. J Neurosurg Spine. 2004;100(1 Suppl):32–7.

    Article  Google Scholar 

  36. Phillips FM, Wetzel FT, Lieberman I, et al. An in vivo comparison of the potential extravertebral cement leak after vertebroplasty and kyphoplasty. Spine. 2002;27:2173–9.

    Article  PubMed  Google Scholar 

  37. Lee YL, Yip KM. The osteoporotic spine. Clin Orthop. 1996;323:91–7.

    Article  PubMed  Google Scholar 

  38. Peh WC, Gilula LA, Peck DD. Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Radiology. 2002;223:121–6.

    Article  PubMed  Google Scholar 

  39. McKiernan F, Jensen R, Faciszewski T, et al. The dynamic mobility of vertebral compression fractures. J Bone Miner Res. 2003;18:24–9.

    Article  PubMed  Google Scholar 

  40. Yamato M, Nishimura G, Kuramochi E, Saiki N, Fujioka M. MR appearance at different ages of osteoporotic compression fractures of the vertebrae. Radiat Med. 1998;16:329–34.

    CAS  PubMed  Google Scholar 

  41. Oner FC. MRI findings of thoracolumbar spine fractures: a categorization based on MRI examinations of 100 fractures. Skeletal Radiol. 1999;28:433–43.

    Article  CAS  PubMed  Google Scholar 

  42. Maynard AS, Jensen ME, Schweickert PA, Marx WF, Short JG, Kallmes DF. Value of bone scan imaging in predicting pain relief from percutaneous vertebroplasty in osteoporotic vertebral fractures. AJNR Am J Neuroradiol. 2000;21:1807–12.

    CAS  PubMed  Google Scholar 

  43. Spivak JM, Johnson MG. Percutaneous treatment of vertebral body pathology. J Am Acad Orthop Surg. 2005;13:6–17.

    PubMed  Google Scholar 

  44. Kim CW, Garfin SR. Percutaneous cement augmentation techniques (vertebroplasty, kyphoplasty). Spine surgery. Tricks of the trade (Chap. 66). 2nd ed. New York: Thieme; 2009.

    Google Scholar 

  45. Bierschneider M, Boszczyk BM, Schmid K, et al. Minimally invasive vertebral augmentation techniques in osteoporotic fractures. Eur J Trauma. 2005;31:442–52.

    Article  Google Scholar 

  46. Hillmeier J, Meeder PJ, Nöldge G, et al. Minimally invasive reduction and internal stabilization of osteoporotic vertebral body fractures (balloon kyphoplasty). Eur J Trauma. 2005;31:280–90.

    Article  Google Scholar 

  47. Mathis JM, Deramond H, Belkoff S, editors. Percutaneous vertebroplasty and kyphoplasty. 2nd ed. New York: Springer; 2006.

    Google Scholar 

  48. Cloft HJ, Jensen ME. Kyphoplasty: an assessment of a new technology. AJNR Am J Neuroradiol. 2007;28:200–3.

    CAS  PubMed  Google Scholar 

  49. Franck H, Boszczyk BM, Bierschneider M, Jaksche H. Interdisciplinary approach to balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures. Eur Spine J. 2003;12 Suppl 2:S163–7.

    Article  PubMed Central  PubMed  Google Scholar 

  50. Manson NA, Phillips FM. Minimally invasive techniques for the treatment of osteoporotic vertebral fractures. J Bone Joint Surg Am. 2006;88-A(8):1862–72.

    Google Scholar 

  51. Phillips FM. Minimally invasive treatments of osteoporotic vertebral compression fractures. Spine. 2003;28(15S):S45–53.

    Article  PubMed  Google Scholar 

  52. Belkoff SM, Mathis JM, Deramond H, Jasper LE. An ex vivo biomechanical evaluation of a hydroxyapatite cement for use with kyphoplasty. AJNR Am J Neuroradiol. 2001;22:1212–6.

    CAS  PubMed  Google Scholar 

  53. Layton KF, Thielen KR, Koch CA, et al. Vertebroplasty, first 1000 levels of a single center: evaluation of the outcomes and complications. AJNR Am J Neuroradiol. 2007;28:683–9.

    CAS  PubMed  Google Scholar 

  54. Mathis JM. Percutaneous vertebroplasty: complication avoidance and technique optimization. AJNR Am J Neuroradiol. 2003;24:1697–706.

    PubMed  Google Scholar 

  55. Laredo JD, Hamze B. Complications of percutaneous vertebroplasty and their prevention. Skeletal Radiol. 2004;33:493–505.

    Article  CAS  PubMed  Google Scholar 

  56. Hulme PA, Krebs J, Ferguson SJ, et al. Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine. 2006;31:1983–2001.

    Article  PubMed  Google Scholar 

  57. Wong W, Mathis JM. Vertebroplasty and kyphoplasty: techniques for avoiding complications and pitfalls. Neurosurg Focus. 2005;18:e2.

    Article  PubMed  Google Scholar 

  58. Taylor RS, Taylor RJ, Fritzell P. Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety. Spine. 2006;31:2747–55.

    Article  PubMed  Google Scholar 

  59. Eck JC, Nachtigall D, Humphreys SC, et al. Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature. Spine J. 2008;8:488–97.

    Article  PubMed  Google Scholar 

  60. Syed MI, Patel NA, Jan S, et al. Intradiskal extravasation with low-volume cement filling in percutaneous vertebroplasty. AJNR Am J Neuroradiol. 2005;26:2397–401.

    PubMed  Google Scholar 

  61. Lin EP, Ekholm S, Hiwatashi A, et al. Vertebroplasty: cement leakage into the disc increases the risk of new fracture of adjacent vertebral body. AJNR Am J Neuroradiol. 2004;25:175–80.

    PubMed  Google Scholar 

  62. Komemushi A, Tanigawa N, Kariya S, et al. Percutaneous vertebroplasty for osteoporotic compression fracture: multivariate study of predictors of new vertebral body fracture. Cardiovasc Intervent Radiol. 2006;29:580–5.

    Article  PubMed  Google Scholar 

  63. Yeom JS, Kim WJ, Choy WS, Lee CK, Chang BS, Kang JW. Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures. J Bone Joint Surg Br. 2003;85:83–9.

    Article  CAS  PubMed  Google Scholar 

  64. Ryu KS, Park CK, Kim MC, et al. Dose-dependent epidural leakage of polymethylmethacrylate after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures. J Neurosurg. 2002;96:S56–61.

    Google Scholar 

  65. Padovani B, Kasriel O, Brunner P, et al. Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty. AJNR Am J Neuroradiol. 1999;20:375–7.

    CAS  PubMed  Google Scholar 

  66. Choe DH, Marom EM, Ahrar K, et al. Pulmonary embolism of polymethylmethacrylate during percutaneous vertebroplasty and kyphoplasty. AJR Am J Roentgenol. 2004;183:1097–102.

    Article  PubMed  Google Scholar 

  67. Pitton MB, Herber S, Koch U, Oberholzer K, Drees P, Düber C. CT-guided vertebroplasty: analysis of technical results, extraosseous cement leakages, and complications in 500 procedures. Eur Radiol. 2008;18:2568–78.

    Article  PubMed  Google Scholar 

  68. Bouza C, Lopez T, Magro A, et al. Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systemic review. Eur Spine J. 2006;21:1–18.

    Google Scholar 

  69. Syed MI, Patel NA, Jan S, et al. New symptomatic vertebral compression fractures within fractures within a year following vertebroplasty in osteoporotic women. AJNR Am J Neuroradiol. 2005;26:1601–4.

    PubMed  Google Scholar 

  70. Grafe IA, Da Fonseca K, Hillmeier J, et al. Reduction of pain and fracture incidence after kyphoplasty: 1-year outcomes of a prospective controlled trial of patients with primary osteoporosis. Osteoporos Int. 2005;16:2005–12.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopaedic Department, Spine Unit, Universitat Autònoma de Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain

    Guillem Saló

Authors
  1. Guillem Saló
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Guillem Saló .

Editor information

Editors and Affiliations

  1. Royal National Orthopaedic Hospital, Stanmore, United Kingdom

    George Bentley

Rights and permissions

Reprints and permissions

Copyright information

© 2014 EFORT

About this entry

Cite this entry

Saló, G. (2014). Kyphoplasty - the Current Treatment for Osteoporotic Vertebral Fractures. In: Bentley, G. (eds) European Surgical Orthopaedics and Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-34746-7_26

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-34746-7_26

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-34745-0

  • Online ISBN: 978-3-642-34746-7

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation