Vertebral augmentation is a minimally invasive treatment option for osteoporotic vertebral compression fractures, particularly in the thoracolumbar spine. Percutaneous vertebroplasty (PVP) stabilizes the affected vertebra by injecting bone cement into the fracture site, helping relieve pain and prevent further collapse.
Percutaneous kyphoplasty (PKP) adds a balloon expansion step before cement injection. By creating a cavity within the vertebral body, PKP can provide better restoration of vertebral height while stabilizing the fracture and reducing pain.
Vertebral augmentation mainly includes two commonly used techniques:
• Percutaneous Vertebroplasty (PVP)
• Percutaneous Kyphoplasty (PKP)
Through a small posterior incision, a specialized trocar is introduced percutaneously into the affected vertebral body under fluoroscopic guidance. After establishing the working channel, bone cement is delivered into the vertebra to stabilize the fracture, limit further collapse, and alleviate pain.
PKP uses a balloon to expand the compressed vertebral body before cement injection. Balloon inflation compacts the surrounding cancellous bone and forms a cavity for cement placement. Cement can then be introduced in stages, helping control injection pressure and reduce the potential for cement leakage.
Both techniques provide vertebral stabilization and pain relief. However, PKP offers an additional vertebral height restoration step through balloon expansion and is generally more suitable when restoration of vertebral height or correction of kyphotic deformity is an important treatment objective.
Both PVP and PKP can provide rapid pain relief and stabilize the affected vertebral segment, helping patients regain mobility and improve daily function. PKP may provide additional benefits in cases where vertebral height restoration and correction of kyphotic deformity are required.
PVP is generally a relatively short procedure, often taking around 30 minutes. With appropriate postoperative management and brace protection when indicated, patients may resume ambulation early. Early mobilization can help reduce complications associated with prolonged bed rest, including pneumonia, pressure ulcers, and deep vein thrombosis.
Restoring and stabilizing vertebral anatomy may also help reduce the long-term effects associated with progressive kyphotic deformity, such as chronic pain, abdominal discomfort, and postural difficulties.
OVCFs are the most common indication for vertebral augmentation. Fragile vertebrae may fracture during relatively low-impact activities such as bending, coughing, sneezing, or lifting. The resulting pain can persist and significantly affect mobility and quality of life. Vertebral augmentation can help stabilize the fractured vertebra and relieve pain.
Certain vertebral lesions, including multiple myeloma, vertebral hemangioma, and osteolytic metastases, may weaken the vertebral body and result in pathological fractures, instability, and severe pain. In appropriately selected cases, vertebral augmentation can reinforce the affected vertebra and provide pain relief.
Under appropriate clinical conditions, vertebral augmentation may also be considered for selected cases of acute vertebral burst fractures or vertebral hematomas, based on the patient's clinical status and imaging findings.
