Kyphoplasty and vertebroplasty: a review

Vertebral bodies are the most common location of osteoporosis-related fragility fractures, with approximately 700 000 occurring annually in the United States alone. The associated morbidities of these fractures are well recognized as chronic pain and anatomic deformities severely damage the physiologic and mental health of those affected. Several modalities aimed at limiting complications secondary to vertebral compression fractures have been developed, all with the end goal of restoring the patient's quality of life. Conservative treatment consists of any combination of limited bed rest, the use of orthotics, bisphosphonates, analgesia, and physical therapy. However, the benefits of conservative modalities are limited by their inability to restore the anatomic height of the compression fracture itself. Thus, minimally invasive procedures such as vertebroplasty and kyphoplasty were developed, with the goal of improving vertebral height and providing improved results over conservative treatment, while avoiding the associated morbidities of large, open surgical decompression and stabilizing procedures. Short-term clinical results have been promising, demonstrating both significant pain reduction and restoration of function, with few surgical complications. in this review, the surgical techniques, clinical results, and complications of both vertebroplasty and kyphoplasty are discussed, along with future directions of vertebral augmentation procedures.