Vertebroplasty and kyphoplasty for the management of osteoporotic vertebral compression fractures

Osteoporotic vertebral compression fractures have previously been treated nonoperatively given the tremendous morbidity associated with open fixation in elderly patients who often have multiple medical comorbidities. With the advent of percutaneous vertebral augmentation techniques, these fractures can now be stabilized using minimally invasive surgical techniques while maintaining a relatively safe risk profile. Vertebroplasty and kyphoplasty provide immediate pain relief in the great majority of patients who have painful, osteoporotic vertebral compression fractures. The balloon used in kyphoplasty may allow for improved height restoration, cavity creation, and decreased cement extravasation rates. The authors discuss the procedural steps, advantages and disadvantages, and results of each technique, recognizing that prospective, randomized controlled studies are necessary to objectively compare the two techniques.