Vertebral fractures, most often due to osteoporosis, are associated with acute or chronic back pain, disability and kyphosis (stooped back). One in five women with a vertebral fracture will sustain another within a year, which may lead to a 'cascade' of fractures. Vertebral fractures impact severely on quality of life and may have serious health consequences such as spinal deformity, immobility, decreased pulmonary function, early satiety and impaired gait. Clinical vertebral fractures are also associated with an 8-fold increase in mortality.
Conservative treatment of vertebral fractures is typically through rest, pain medication, bracing and muscle relaxants. VP and BKP are two minimally invasive techniques that consist of inserting a bone cement into the compressed vertebra and stabilising the fracture.
In the studies observed, the review found that:
- Overall, VP and BKP are relatively safe procedures and serious complications are rare.
- In the short term, VP and BKP provide quicker pain relief and mobility recovery than does conservative treatment alone.
- VP and BKP are able to stabilise the fracture and in some cases restore lost vertebral body height.
- The added benefit of injecting cement over a sham-controlled surgery is still contentious.
- The clinical outcome after VP and BKP appears to be dependent on the time elapsed between the fracture and the intervention.
- The incidence of new (including adjacent) vertebral fractures are similar after VP or BKP, but longer term data are required.
- Further studies are needed with standardised and systematic reporting of health outcomes and complications.