What is the role of kyphoplasty or vertebroplasty in patients with osteoporotic spinal fractures?

Vertebroplasty and kyphoplasty can be grouped together as vertebral augmentation. They have a single indication: To reduce pain arising from a documented vertebral fracture. Kyphoplasty has an inflatable balloon and in theory, can improve vertebral height prior to introduction of the cement. I am not confident that height restoration is clinically significant with kyphoplasty.

In general, with most vertebral fractures the pain is self-limited Most guidelines suggest a few weeks of persistent back pain before vertebral augmentation is considered. These procedures should not be done acutely by aggressive interventional radiologists who are alerted to the patient with a vertebral fracture because radiology read the x-rays and MRIs. Again, some...