Open Access, Peer-reviewed, Quarterly
pISSN 1225-1682
eISSN 2287-9293
    J Korean Fract Soc. 2018 Jul;31(3):114-121. Korean.
    Published online Jul 25, 2018.
    https://doi.org/10.12671/jkfs.2018.31.3.114
    Copyright © 2018 The Korean Fracture Society. All rights reserved.
    Review

    Treatment Options of Osteoporotic Vertebral Compression Fractures

    Yu Mi Kim, M.D., Tae Kyun Kim, M.D.,* Dae Moo Shim, M.D.,* and Kyeong Hoon Lim, M.D.*
      • Department of Orthopaedic Surgery, Wonkwang University Sanbon Hospital, Gunpo, Korea.
      • *Department of Orthopaedic Surgery, Wonkwang University School of Medicine, Iksan, Korea.
    • Correspondence to: Tae Kyun Kim, M.D. Department of Orthopaedic Surgery, Wonkwang University School of Medicine, 460 Iksan-daero, Iksan 54538, Korea. Tel: +82-63-859-1360, Fax: +82-63-859-1340, Email: osktg@wonkwang.ac.kr

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    This paper reviews previous studies on the treatment of osteoporotic vertebral compression fractures in elderly patients to determine what factors should be considered for successful treatment. In osteoporotic vertebral compression fractures, the primary treatment is conservative treatments. Other treatments include osteoporosis treatment, pain control, orthosis, and physical therapy. Recently, percutaneous catheterization or balloon plasty is performed for rapid pain recovery and early ambulation. Percutaneous catheterization or balloon posterior plasty is effective in reducing pain and improving the activity ability. Surgical treatment should be considered in cases of nonunion or osteonecrosis, dent, deformation, and spinal cord compression after conservative treatment has failed. In surgical treatment, posterior spinal fixation and vertebroplasty are more advantageous in terms of the amount of bleeding, operation time compared to the anterior approach, but the most appropriate method should be selected through the patient's condition and understanding of each surgical method.

    Keywords
    Osteoporosis; Vertebral compression fracture; Conservative treatment; Operative treatment

    Figures

    Fig. 1
    Kyphoplasty for an osteoporotic vertebral fracture. (A) Guide pin inserted through the pedicle. (B) After the guide pin is removed, balloon is infiltrated. (C) After the balloon removed, a bone filler device is inserted through cannula, and cement is injected (packed) into the void.

    Fig. 2
    Preoperative simple radiography (A), preoperative magnetic resonance imaging (B), and postoperative simple radiography (C) of a 72-year-old female patient who had an osteoporotic L4 vertebral compression fracture. She underwent posterior decompression and fusion combined with vertebral body augmentation with polymethylmethacrylate to provide anterior spinal column support.

    Fig. 3
    Algorithm for the management of osteoporotic vertebral fractures. Tx: therapy.

    Notes

    Financial support:This study was supported grant in 2018 from Wonkwang University.

    Conflict of interests:None.

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    MeSH Terms
    Aged
    Catheterization
    Catheters
    Early Ambulation
    Fractures, Compression*
    Hemorrhage
    Humans
    Methods
    Orthotic Devices
    Osteonecrosis
    Osteoporosis
    Spinal Cord Compression
    Vertebroplasty
    Metrics
    Share
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