Painful vertebral body compression fractures are prevalent in elderly patients. Two-thirds
of patients will have spontaneous resolution of pain in 4 to 6 weeks and initial management
is nonoperative with pain management and bracing. A focused history and exam can identify
patients likely to benefit from vertebral body augmentation (e.g., vertebroplasty
or kyphoplasty). Patients with persistent back pain and bone marrow edema on magnetic
resonance imaging may benefit from injection of cement into the fractured vertebral
body with either vertebroplasty or kyphoplasty. Patients most likely to benefit are
those with severe pain refractory to nonoperative management who are offered intervention
within 3 weeks. The procedure is usually performed as an outpatient with rare complications.
Most patients report immediate, durable pain relief.
Keywords
osteoporosis - vertebral compression fracture - vertebral body augmentation - kyphoplasty
- vertebroplasty - interventional radiology
