Vertebral Compression Fractures: Evaluation and Management

Overview

Journal Semin Intervent Radiol

Specialty Radiology

Date 2020 May 19

PMID 32419735

Citations 5

Authors

Sreekumar Madassery

Affiliations

Soon will be listed here.

Abstract

Painful vertebral body compression fractures are prevalent in elderly patients. Two-thirds of patients will have spontaneous resolution of pain in 4 to 6 weeks and initial management is nonoperative with pain management and bracing. A focused history and exam can identify patients likely to benefit from vertebral body augmentation (e.g., vertebroplasty or kyphoplasty). Patients with persistent back pain and bone marrow edema on magnetic resonance imaging may benefit from injection of cement into the fractured vertebral body with either vertebroplasty or kyphoplasty. Patients most likely to benefit are those with severe pain refractory to nonoperative management who are offered intervention within 3 weeks. The procedure is usually performed as an outpatient with rare complications. Most patients report immediate, durable pain relief.

Citing Articles

Comparison of the efficacy and safety of unilateral and bilateral approach kyphoplasty in the treatment of osteoporotic vertebral compression fractures: A meta-analysis.

Sun Y, Li X, Ma S, Chong H, Cai T, Li K Jt Dis Relat Surg. 2024; 35(3):491-503.

PMID: 39189557 PMC: 11411882. DOI: 10.52312/jdrs.2024.1701.

Radiomics Based on Multimodal magnetic resonance imaging for the Differential Diagnosis of Benign and Malignant Vertebral Compression Fractures.

Geng W, Zhu J, Li M, Pi B, Wang X, Xing J Orthop Surg. 2024; 16(10):2464-2474.

PMID: 38982652 PMC: 11456728. DOI: 10.1111/os.14148.

Deep learning-based automated high-accuracy location and identification of fresh vertebral compression fractures from spinal radiographs: a multicenter cohort study.

Zhang H, Xu R, Guo X, Zhou D, Xu T, Zhong X Front Bioeng Biotechnol. 2024; 12:1397003.

PMID: 38812917 PMC: 11135169. DOI: 10.3389/fbioe.2024.1397003.

Commentary on "Utilization of Vertebroplasty/Kyphoplasty in the Management of Compression Fractures: National Trends and Predictors of Vertebroplasty/Kyphoplasty".

Jabbouri S, Whang P Neurospine. 2024; 20(4):1140-1141.

PMID: 38171284 PMC: 10762381. DOI: 10.14245/ns.2347266.633.

Pharmacological options for pain control in patients with vertebral fragility fractures.

Tanna N, Ong T Osteoporos Sarcopenia. 2022; 8(3):93-97.

PMID: 36268497 PMC: 9577215. DOI: 10.1016/j.afos.2022.09.003.

References

Chandra R, Maingard J, Asadi H, Slater L, Mazwi T, Marcia S . Vertebroplasty and Kyphoplasty for Osteoporotic Vertebral Fractures: What Are the Latest Data?. AJNR Am J Neuroradiol. 2017; 39(5):798-806. PMC: 7410658. DOI: 10.3174/ajnr.A5458. View

Jay B, Ahn S . Vertebroplasty. Semin Intervent Radiol. 2014; 30(3):297-306. PMC: 3773069. DOI: 10.1055/s-0033-1353483. View

Dohm M, Black C, Dacre A, Tillman J, Fueredi G . A randomized trial comparing balloon kyphoplasty and vertebroplasty for vertebral compression fractures due to osteoporosis. AJNR Am J Neuroradiol. 2014; 35(12):2227-36. PMC: 7965303. DOI: 10.3174/ajnr.A4127. View

Alexandru D, So W . Evaluation and management of vertebral compression fractures. Perm J. 2012; 16(4):46-51. PMC: 3523935. DOI: 10.7812/TPP/12-037. View

Tsoumakidou G, Too C, Koch G, Caudrelier J, Cazzato R, Garnon J . CIRSE Guidelines on Percutaneous Vertebral Augmentation. Cardiovasc Intervent Radiol. 2017; 40(3):331-342. DOI: 10.1007/s00270-017-1574-8. View

Clark W, Bird P, Gonski P, Diamond T, Smerdely P, McNeil H . Safety and efficacy of vertebroplasty for acute painful osteoporotic fractures (VAPOUR): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet. 2016; 388(10052):1408-1416. DOI: 10.1016/S0140-6736(16)31341-1. View

Baerlocher M, Saad W, Dariushnia S, Barr J, McGraw J, Nikolic B . Quality improvement guidelines for percutaneous vertebroplasty. J Vasc Interv Radiol. 2013; 25(2):165-70. DOI: 10.1016/j.jvir.2013.09.004. View

Brinjikji W, Comstock B, Gray L, Kallmes D . Local Anesthesia with Bupivacaine and Lidocaine for Vertebral Fracture trial (LABEL): a report of outcomes and comparison with the Investigational Vertebroplasty Efficacy and Safety Trial (INVEST). AJNR Am J Neuroradiol. 2010; 31(9):1631-4. PMC: 7964994. DOI: 10.3174/ajnr.A2145. View

Syed M, Avutu B, Shaikh A, Sparks H, Mohammed M, Morar K . Vertebral osteomyelitis following vertebroplasty: is acne a potential contraindication and are prophylactic antibiotics mandatory prior to vertebroplasty?. Pain Physician. 2009; 12(4):E285-90. View

10.

Nussbaum D, Gailloud P, Murphy K . A review of complications associated with vertebroplasty and kyphoplasty as reported to the Food and Drug Administration medical device related web site. J Vasc Interv Radiol. 2004; 15(11):1185-92. DOI: 10.1097/01.RVI.0000144757.14780.E0. View

11.

Evans A, Kip K, Brinjikji W, Layton K, Jensen M, Gaughen J . Randomized controlled trial of vertebroplasty versus kyphoplasty in the treatment of vertebral compression fractures. J Neurointerv Surg. 2015; 8(7):756-63. DOI: 10.1136/neurintsurg-2015-011811. View

12.

Firanescu C, de Vries J, Lodder P, Venmans A, Schoemaker M, Smeets A . Vertebroplasty versus sham procedure for painful acute osteoporotic vertebral compression fractures (VERTOS IV): randomised sham controlled clinical trial. BMJ. 2018; 361:k1551. PMC: 5941218. DOI: 10.1136/bmj.k1551. View

13.

Chehab M, Thakor A, Tulin-Silver S, Connolly B, Cahill A, Ward T . Adult and Pediatric Antibiotic Prophylaxis during Vascular and IR Procedures: A Society of Interventional Radiology Practice Parameter Update Endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian.... J Vasc Interv Radiol. 2018; 29(11):1483-1501.e2. DOI: 10.1016/j.jvir.2018.06.007. View

14.

Saliou G, Rutgers D, Kocheida E, Langman G, Meurin A, Deramond H . Balloon-related complications and technical failures in kyphoplasty for vertebral fractures. AJNR Am J Neuroradiol. 2009; 31(1):175-9. PMC: 7964083. DOI: 10.3174/ajnr.A1783. View

15.

Klazen C, Lohle P, de Vries J, Jansen F, Tielbeek A, Blonk M . Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet. 2010; 376(9746):1085-92. DOI: 10.1016/S0140-6736(10)60954-3. View

16.

Chang V, Holly L . Bracing for thoracolumbar fractures. Neurosurg Focus. 2014; 37(1):E3. DOI: 10.3171/2014.4.FOCUS1477. View

17.

Patel I, Rahim S, Davidson J, Hanks S, Tam A, Walker T . Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions-Part II: Recommendations: Endorsed by the Canadian Association.... J Vasc Interv Radiol. 2019; 30(8):1168-1184.e1. DOI: 10.1016/j.jvir.2019.04.017. View

18.

Anderson P, Froyshteter A, Tontz Jr W . Meta-analysis of vertebral augmentation compared with conservative treatment for osteoporotic spinal fractures. J Bone Miner Res. 2012; 28(2):372-82. DOI: 10.1002/jbmr.1762. View

19.

Bartynski W . Clinical, anatomic, and imaging correlation in spine-related pain: the essential elements. Tech Vasc Interv Radiol. 2009; 12(1):2-10. DOI: 10.1053/j.tvir.2009.06.002. View

20.

Noriega D, Rodriguez-Monsalve F, Ramajo R, Sanchez-Lite I, Toribio B, Ardura F . Long-term safety and clinical performance of kyphoplasty and SpineJack® procedures in the treatment of osteoporotic vertebral compression fractures: a pilot, monocentric, investigator-initiated study. Osteoporos Int. 2018; 30(3):637-645. DOI: 10.1007/s00198-018-4773-5. View