Vertebroplasty for Vertebral Compression Fracture : Perforation, Percutaneous Vertebroplasty, Balloon Kyphoplasty

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  • 圧迫骨折に対する椎体形成術
  • —穿孔術からBKPまで—

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  Over the past 20 years, vertebroplasty has become a widely adopted treatment for vertebral compression fractures unresponsive to traditional conservative treatment. Although vertebroplasty might provide immediate pain relief and improved function in patients with vertebral compression fracture, patient selection is the most critical factor in predicting a satisfactory result. There should be intractable pain present in weight bearing postures and magnetic resonance imaging (MRI) evidence of bone marrow edema. Two recently published randomized controlled trials showed no superiority of vertebroplasty over nonsurgical management or over a simulated procedure (sham), while several studies have demonstrated that kyphoplasty and vertebroplasty provide better clinical outcomes to nonsurgical management in randomized controlled studies. The vertebral perforation procedure is as effective as vertebroplasty for early-stage vertebral compression fractures with mild vertebral compression. However, percutaneous vertebroplasty or kyphoplasty should be considered in patients with severe vertebral compression in the subacute stage.

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