Vertebroplasty and Kyphoplasty

Mark N. Malinowski, D.O.
Pain Fellow, Department of Anesthesiology
Texas Tech University Health Sciences Center
Lubbock TX

Allen W Burton, M.D.
Professor and Chairman
Department of Pain Medicine
UT MD Anderson Cancer Center
Houston TX 

Introduction - TOP

Vertebroplasty and kyphoplasty are spine fracture stabilization techniques that are performed for relief of pain following vertebral compression fractures (VCFs) most commonly secondary to osteoporosis.  Osteoporosis is a degenerative bone disease that affects approximately 44 million people worldwide. The incidence increases with age although osteoporosis may present in any decade of life. All ethnicities are affected, however the frequency is increasing most rapidly in women of Hispanic descent.1 

Several etiologies have been known to promote osteoclastic activity and are the basis for its classification. Primary osteoporosis can be divided into type 1, or postmenopausal osteoporosis, where estrogen deficiency may promote bone resorption, and type 2, or senile osteoporosis, which may be preceded by dietary vitamin deficiency (Vitamin D, calcium) or tissue insensitivity in the elderly. Secondary osteoporosis represents those cases where disease related hormone imbalance (hyperparathyroidism, hypogonadism) or drug-related side effects (e.g. glucocorticoids) are the cause.2 

Osteoporosis is widely recognized as a cause of boney fracture. While some fractures may be minor, other fractures of the pelvis, long bones and vertebrae can have a significant impact on the physical and mental health of the patient. An overwhelming majority of these fractures result in severe pain, immobilization and debilitation.2 

Vertebral compression fractures (VCFs) in particular are associated with significant debilitation, and the mortality rate is directly proportional to the number of VCFs.3  By 2025, direct healthcare costs of VCFs are estimated to reach 25 billion dollars.1  Initial treatment of VCFs includes rest, analgesics, bracing and treatment of the underlying cause (i.e., osteoporosis).

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