Percutaneous Vertebral Augmentation

Over 700,000 osteoporotic compression fractures occur each year in the United States. These vertebral fractures are associated with significant morbidity and mortality and represent a tremendous personal and societal burden. Percutaneous vertebroplasty (PVP) involves the injection of polymethylmethacrylate to strengthen a vertebra. This minimally invasive method, which has been adopted by practitioners since 1980s to treat symptomatic compression fracture is reported to provide quick pain relief in 90% of patients, with only infrequent, mostly minor complications. Kyphoplasty (KP) is an extension of PVP that uses an inflatable bone tamp to restore the vertebral body toward its original height while creating a cavity to be filled with bone cement. Reported results indicate that KP is a safe procedure associated with a lower risk of cement leak that not only yields quick pain relief, like PVP, but also restores vertebral height, potentially decreasing kyphosis and improving pulmonary mechanics as well. FDA device/drug status: Approved for this indication: polymethylmethacrylate bone cement; Investigational/ not approved: synthetic bone substitutes. Authors DT and IHL acknowledge financial relationships (grant research support from Kyphon Inc., Sunnyvale, CA, IHL: consultant for DePuy Spine and Kyphon Inc.), which may indirectly relate to the subject of this manuscript.