Osteoporotic vertebral fractures and pathological vertebral lesions are frequent clinical
situations causing severe back pain. The pharmacological treatment of the underlying
disease and the analgetic treatment of the associated back pain usually do not rid
the patient's back pain completely and are insufficient to prevent the fracture-weakened
vertebral body from further fracturing with long term consequences for the biomechanical
competence of the entire spine. In the last 10 years the minimal invasive treatment
options vertebroplasty (VP) and balloon kyphoplasty (BK) have spread quickly because
these procedures appeared to be promising treatments to stop the fracture and vertebral
lesion associated back pain and to internally stabilize a fractured vertebral body.
Numerous published reports on VP and BK appeared to support the notion of an immediate
and lasting pain reduction after VP and BK in additon to a prevention of further fracturing
of the treated vertebrae. The first three randomized controlled and partly blinded
trials have been published this year. Two of these trials demonstrate that VP does
not result in a better pain control than a sham operation whereas BK was shown to
reduce back pain due to verterbal fractures for at least 12 months. Considering that
more than 1.5 million people world-wide have been treated with VP and BK until now
this work discusses the recent trials and suggests clinical and academic consequences
on the basis of the most recent evidence.
vertebroplasty - kyphoplasty - balloon kyphoplasty - back pain - osteoporosis
