J Korean Fract Soc.  2018 Jul;31(3):114-121. 10.12671/jkfs.2018.31.3.114.

Treatment Options of Osteoporotic Vertebral Compression Fractures

• Kim YM
• Kim TK
• Shim DM
• Lim KH

• KMID: 2417153
• DOI: http://doi.org/10.12671/jkfs.2018.31.3.114

Abstract

This paper reviews previous studies on the treatment of osteoporotic vertebral compression fractures in elderly patients to determine what factors should be considered for successful treatment. In osteoporotic vertebral compression fractures, the primary treatment is conservative treatments. Other treatments include osteoporosis treatment, pain control, orthosis, and physical therapy. Recently, percutaneous catheterization or balloon plasty is performed for rapid pain recovery and early ambulation. Percutaneous catheterization or balloon posterior plasty is effective in reducing pain and improving the activity ability. Surgical treatment should be considered in cases of nonunion or osteonecrosis, dent, deformation, and spinal cord compression after conservative treatment has failed. In surgical treatment, posterior spinal fixation and vertebroplasty are more advantageous in terms of the amount of bleeding, operation time compared to the anterior approach, but the most appropriate method should be selected through the patient's condition and understanding of each surgical method.

Keyword

Osteoporosis; Vertebral compression fracture; Conservative treatment; Operative treatment

MeSH Terms

Aged
Catheterization
Catheters
Early Ambulation
Fractures, Compression*
Hemorrhage
Humans
Methods
Orthotic Devices
Osteonecrosis
Osteoporosis
Spinal Cord Compression
Vertebroplasty

Figure

• 

  Fig. 1 Kyphoplasty for an osteoporotic vertebral fracture. (A) Guide pin inserted through the pedicle. (B) After the guide pin is removed, balloon is infiltrated. (C) After the balloon removed, a bone filler device is inserted through cannula, and cement is injected (packed) into the void.

• 

  Fig. 2 Preoperative simple radiography (A), preoperative magnetic resonance imaging (B), and postoperative simple radiography (C) of a 72-year-old female patient who had an osteoporotic L4 vertebral compression fracture. She underwent posterior decompression and fusion combined with vertebral body augmentation with polymethylmethacrylate to provide anterior spinal column support.

• 

  Fig. 3 Algorithm for the management of osteoporotic vertebral fractures. Tx: therapy.

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