How are vertebral fractures treated in patients with osteoporosis?

Updated: Jan 19, 2021
  • Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: Felix S Chew, MD, MBA, MEd  more...
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Answer

Vertebral body stenting has been introduced as a novel percutaneous cement–augmenting technique for the treatment of vertebral body compression fractures and has produced controversy as to which technique is better—vertebral body stenting versus kyphoplasty—for the treatment of osteoporotic vertebral compression fractures. [41]

Werner et al set up a 2-armed randomized, controlled trial in patients with a total of 100 fresh osteoporotic vertebral compression fractures treated with either balloon kyphoplasty or vertebral body stenting. The purpose of this study was to clarify whether there are relevant differences between balloon kyphoplasty and vertebral body stenting with regard to perioperative and postoperative findings. The primary outcome was of the postinterventional change in the kyphotic angle on radiographs. The secondary outcomes were the maximum pressure of the balloon during inflation, radiation exposure time, perioperative complications, and cement leakage. [41]  The trial concluded that there was no beneficial effect of vertebral body stenting over balloon kyphoplasty among patients with painful osteoporotic vertebral fractures with regard to kyphotic correction, cement leakage, radiation exposure time, or neurologic sequelae. Vertebral body stenting was associated with significantly higher pressures during balloon inflation and more material-related complications.


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