Vertebral augmentation is a minimally invasive treatment for osteoporotic vertebral compression fractures.
For thoracolumbar fractures, percutaneous vertebroplasty (PVP) is commonly used. During the procedure, bone cement is delivered into the affected vertebra to stabilize the fracture and relieve pain, while helping restore vertebral height.
Percutaneous kyphoplasty (PKP) involves balloon expansion within the vertebral body before cement injection. This technique stabilizes the fractured vertebra, alleviates pain, and provides greater potential for vertebral height restoration.
Vertebral augmentation mainly includes:
• Percutaneous Vertebroplasty (PVP)
• Balloon Kyphoplasty (PKP)
A small posterior incision of approximately 2 mm is made, followed by percutaneous insertion of a specialized trocar into the vertebral body under fluoroscopic guidance. After establishing a working channel, bone cement is injected to stabilize the fractured vertebra, limit further collapse, and relieve pain.
After balloon expansion, the surrounding cancellous bone is compacted to create a cavity within the vertebral body. Bone cement is then injected in stages. This approach helps control injection pressure and reduce the risk of cement leakage.
PKP uses a balloon and specialized instruments to expand the compressed vertebral body before cement injection. Compared with PVP, PKP provides better vertebral height restoration.
Both PKP and PVP can provide rapid and effective pain relief while stabilizing the affected vertebra and helping prevent further collapse. PKP offers additional advantages when vertebral height restoration and correction of kyphotic deformity are treatment objectives.
PVP is generally a short procedure, typically requiring approximately 30 minutes. With appropriate postoperative management and brace protection when indicated, many patients can resume ambulation within 24 hours. Early mobilization helps reduce complications associated with prolonged bed rest, including pneumonia, pressure ulcers, and deep vein thrombosis.
Vertebral stabilization may also help reduce chronic pain, abdominal distension, and postural difficulties associated with progressive kyphotic deformity.
OVCFs are the most common indication for vertebral augmentation. Reduced bone density and vertebral fragility can cause fractures during relatively minor activities such as bending, coughing, sneezing, or lifting. These fractures may result in persistent pain and reduced quality of life. Vertebral augmentation can stabilize the vertebra, relieve pain, and improve mobility.
Conditions such as multiple myeloma, vertebral hemangioma, and osteolytic metastases may weaken the vertebral body and lead to instability, pathological fractures, severe pain, or neurological compression. In appropriately selected cases, vertebral augmentation can reinforce the affected vertebra and provide pain relief.
In selected cases, acute vertebral burst fractures or vertebral hematomas may also be considered for vertebral augmentation under appropriate clinical conditions.
