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. 2013 Jun 17:6:205-14.
doi: 10.2147/JMDH.S31659. Print 2013.

Vertebral compression fractures: a review of current management and multimodal therapy

Cyrus C Wong  1 , Matthew J McGirt
Affiliations

Vertebral compression fractures: a review of current management and multimodal therapy

Cyrus C Wong et al. J Multidiscip Healthc. .

Abstract

Vertebral compression fractures are a prevalent disease affecting osteoporotic patients. When symptomatic, they cause significant pain and loss of function and have a high public health impact. In this paper we outline the diagnosis and management of these patients, with evidence-based review of treatment outcomes for the various therapeutic options. Diagnosis involves a clinical history focusing on the nature of the patient's pain as well as various imaging studies. Management is multimodal in nature and starts with conservative therapy consisting of analgesic medication, medication for osteoporosis, physical therapy, and bracing. Patients who are refractory to conservative management may be candidates for vertebral augmentation through either vertebroplasty or kyphoplasty.

Keywords: bracing; kyphoplasty; osteoporosis; vertebral compression fractures; vertebroplasty.

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Figures

Figure 1
Figure 1
Lateral radiograph demonstrates biconcave-appearing compression fractures at L2 and L3, showing progression in loss of height in these X-rays taken a year apart.
Figure 2
Figure 2
Sagittal T2 magnetic resonance imaging demonstrating a traumatic burst fracture at L4 with bony retropulsion and canal compromise requiring open surgical decompression and fixation. Note: A concomitant acute compression fracture at L1 (note the bony edema) was treated with kyphoplasty in the same surgery.
Figure 3
Figure 3
Nuclear medicine bone scan demonstrating increased uptake at a T7 fracture.
Figure 4
Figure 4
Intraoperative images showing lateral and anteroposterior fluoroscopic images, after the injection of polymethylmethacrylate.
Figure 5
Figure 5
Pre- and postoperative X-rays demonstrating the restoration of vertebral body height after kyphoplasty.
See this image and copyright information in PMC

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