Spinal augmentation for vertebral body fractures in the elderly population
- PMID: 40944849
- DOI: 10.1007/s11357-025-01842-z
Spinal augmentation for vertebral body fractures in the elderly population
Abstract
Osteoporotic vertebral body fractures (OVBFs) are a highly prevalent pathology in the United States elderly population and can result in height loss and kyphotic deformity. While minimally invasive surgical techniques such as percutaneous kyphoplasty (PKP) and vertebroplasty (PVP) are commonly used, the efficacy of these techniques in older individuals is unknown. By examining the current body of evidence, we aim to assess the efficacy of these procedures within the context of appropriate grading of levels of evidence. This narrative review was conducted by searching multiple databases, including articles pertaining to vertebral augmentation procedures in elderly patients. Articles were then graded for levels of evidence, as outlined by the Oxford Centre for Evidence-Based Medicine (OCEBM). Literature suggests that both procedures are generally safe in advanced-age patients, can reliably and sustainably decrease pain, and may be augmented with a multitude of adjunctive/perioperative care options. Such efforts include pedicle screw fixation with or without fusion, intraoperative lidocaine injection, erector spinae plane block, and rehabilitation efforts, in addition to the use of dexmedetomidine or the combined use of remimazolam besylate and sufentanil analgesics. The most dreaded complications of both procedures are bone cement extravasation and refracture, which likely occur more frequently after PKP. Both procedures have demonstrated efficacy in the domain of anatomical correction. PKP and PVP appear to safely restore quality of life in elderly patients, yet the finer details of each procedure must be explored with higher levels of evidence to account for potential differences in complication profiles and care options.
Keywords: Elderly; Kyphoplasty; Minimally invasive spine surgery; Vertebroplasty.
© 2025. The Author(s), under exclusive licence to American Aging Association.
Conflict of interest statement
Declarations. Ethics approval and consent to participate: Ethical approval and consent to participate were not required for this narrative review. Consent for publication: Consent for publication was not required for this narrative review. Competing interests: The authors report no financial or non-financial interests directly or indirectly related to this work.
References
-
- Gardner MJ, Demetrakopoulos D, Shindle MK, Griffith MH, Lane JM. Osteoporosis and skeletal fractures. HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery. 2006;2:62–9. https://doi.org/10.1007/s11420-005-0137-8 . - DOI - PubMed
-
- Hudson M, Meyer J, Evans A, Krishna C, Smith ZA, Bakhsheshian J. Evaluating osteoporosis and bone quality in the aging spine: modern considerations for surgical management in the geriatric population. Geroscience. 2024;46:5287–301. https://doi.org/10.1007/s11357-024-01171-7 . - DOI - PubMed - PMC
-
- Lee S-K, Jun D-S, Lee D-K, Baik J-M. Clinical characteristics of elderly people with osteoporotic vertebral compression fracture based on a 12-year single-center experience in Korea. Geriatrics. 2022;7:123. https://doi.org/10.3390/geriatrics7060123 . - DOI - PubMed - PMC
-
- Gold LS, Suri P, O’Reilly MK, Kallmes DF, Heagerty PJ, Jarvik JG. Mortality among older adults with osteoporotic vertebral fracture. Osteoporos Int. 2023;34:1561–75. https://doi.org/10.1007/s00198-023-06796-6 . - DOI - PubMed - PMC
-
- Gutiérrez-González R, Royuela A, Zamarron A. Survival following vertebral compression fractures in population over 65 years old. Aging Clin Exp Res. 2023;35:1609–17. https://doi.org/10.1007/s40520-023-02445-4 . - DOI - PubMed - PMC
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