Editorial

Augmentation Procedures for Osteoporotic Vertebral Fractures-An Ongoing Experiment or Emerging Standard of Care?

Authors: E Michael Lewiecki, MD, FACP

Abstract

The history of vertebral augmentation procedures is an interesting one. Vertebroplasty was first performed in France in 1984 and reported in a French language journal in 1987.1 This publication did not create great international attention, but served to initiate further investigation by others. It was not until 1994 that the procedure was performed in the US. When a retrospective review of 47 vertebroplasties in 29 patients with osteoporotic vertebral fractures was published in an English language journal a few years later,2 it set in motion a series of events that led to a paradigm shift in clinical thinking about the management of vertebral fractures—from “benign neglect” to active intervention. A remarkable 90% of patients in that study were reported to have significant pain relief immediately after the procedure.

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References

1. Galibert P, Deramond H, Rosat P, et al. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 1987;33:166–168.
 
2. Jensen ME, Evans AJ, Mathis JM, et al. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol 1997;18:1897–1904.
 
3. Garfin SR, Yuan HA, Reiley MA. New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine 2001;26:1511–1515.
 
4. Machinis TG, Fountas KN, Feltes CH, et al. Pain outcome and vertebral body height restoration in patients undergoing kyphoplasty. South Med J 2006;99:457–460.
 
5. Neviaser A, Toro-Arbelaez JB, Lane JM. Is kyphoplasty the standard of care for compression fractures in the spine, especially in the elderly? Am J Orthop 2005;34:425–429.
 
6. Barr JD, Barr MS, Lemley TJ, et al. Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 2000;25:923–928.