Trends in Vertebral Augmentation Practice for Osteoporotic Vertebral Fracture

Öz

Osteoporosis is characterized by low bone mass, primarily affecting older individuals and a common complication is vertebral fractures. The collapse-induced height loss in vertebrae can result in spinal instability and progressive kyphotic deformity. Surgical intervention for osteoporotic vertebrae poses challenges due to poor bone quality and frequent medical comorbidities. In recent years, it has become the predominant method for vertebral augmentation in acute fractures, aiming to relieve pain, strengthen the vertebral structure, and prevent deformities by restoring height. These procedures involve percutaneous placement of cannulas into each collapsed vertebral body through a unipedicular or bipedicular approach. Novel products are emerging to strengthen vertebrae in treating osteoporotic compression fractures. Balloon kyphoplasty and vertebroplasty are widely accepted and recognized as effective vertebral augmentation methods. Treatment guidelines are evolving with the introduction of innovative systems like Vertebral Body Stenting, Titanium Mesh, and Sky Bone Expander, claiming to achieve exceptional vertebral height restoration. Controversies persist regarding the optimal timing for vertebral augmentation post-fracture. Polymethylmethacrylate cement is extensively used to stabilize fractured vertebral bodies. Additionally, new calcium phosphate-based nanocomposite cements are gaining prominence. These advancements underscore the ongoing development in the treatment of osteoporotic vertebral compression fractures. Each innovative implant introduces unique features and indications. Precise confirmation of the source of the painful fracture is crucial for effective and safe treatment, ensuring proper timing and indication.

Anahtar Kelimeler

• Osteoporosis
• Osteoporotic vertebral fracture
• Vertebral augmentation

Kaynakça

1. Aebli, N., Goss, B. G., Thorpe, P., Williams, R., & Krebs, J. (2006). In vivo temperature profile of intervertebral discs and vertebral endplates during vertebroplasty: an experimental study in sheep. Spine, 31(15), 1674–1679.
2. Baecker, N., Tomic, A., Mika, C., Gotzmann, A., Platen, P., Gerzer, R., & Heer, M. (2003). Bone resorption is induced on the second day of bed rest: results of a controlled crossover trial. Journal of applied physiology (Bethesda, Md.: 1985), 95(3), 977–982.
3. Ensrud, K. E., & Schousboe, J. T. (2011). Clinical practice. Vertebral fractures. The New England journal of medicine, 364(17), 1634–1642.
4. Farrokhi, M. R., Alibai, E., & Maghami, Z. (2011). Randomized controlled trial of percutaneous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures. Journal of neurosurgery. Spine, 14(5), 561–569.
5. Gangi, A., Sabharwal, T., Irani, F. G., Buy, X., Morales, J. P., Adam, A., & Standards of Practice Committee of the Society of Interventional Radiology (2006). Quality assurance guidelines for percutaneous vertebroplasty. Cardiovascular and interventional radiology, 29(2), 173–178.
6. Gehlbach, S. H., Burge, R. T., Puleo, E., & Klar, J. (2003). Hospital care of osteoporosis-related vertebral fractures. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 14(1), 53–60.
7. Kortebein, P., Symons, T. B., Ferrando, A., Paddon-Jones, D., Ronsen, O., Protas, E., Conger, S., Lombeida, J., Wolfe, R., & Evans, W. J. (2008). Functional impact of 10 days of bed rest in healthy older adults. The journals of gerontology. Series A, Biological sciences and medical sciences, 63(10), 1076–1081.
8. Longo, U. G., Loppini, M., Denaro, L., Maffulli, N., & Denaro, V. (2012). Osteoporotic vertebral fractures: current concepts of conservative care. British medical bulletin, 102, 171–189.

9. Lu, Q., Liu, C., Wang, D., Liu, H., Yang, H., & Yang, L. (2019). Biomechanical evaluation of calcium phosphate-based nanocomposite versus polymethylmethacrylate cement for percutaneous kyphoplasty. The spine journal : official journal of the North American Spine Society, 19(11), 1871–1884.
10. Luo, Y., Yang, D. M., Yang, H. M., Wu, D., & Xie, F. Y. (2023). Innovative minimally invasive implants for osteoporosis vertebral compression fractures. Frontiers in medicine, 10, 1161174.
11. Jin, C., Xu, G., Weng, D., Xie, M., & Qian, Y. (2018). Impact of Magnetic Resonance Imaging on Treatment-Related Decision Making for Osteoporotic Vertebral Compression Fracture: A Prospective Randomized Trial. Medical science monitor : international medical journal of experimental and clinical research, 24, 50–57.
12. Johnell, O., & Kanis, J. (2005). Epidemiology of osteoporotic fractures. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 16 Suppl 2, S3–S7.
13. Marie, P. J., & Kassem, M. (2011). Extrinsic mechanisms involved in age-related defective bone formation. The Journal of clinical endocrinology and metabolism, 96(3), 600–609. https://doi.org/10.1210/jc.2010-2113
14. Mathis, J. M., Ortiz, A. O., & Zoarski, G. H. (2004). Vertebroplasty versus kyphoplasty: a comparison and contrast. AJNR. American journal of neuroradiology, 25(5), 840–845.
15. Patel, N., Jacobs, D., John, J., Fayed, M., Nerusu, L., Tandron, M., Dailey, W., Ayala, R., Sibai, N., Forrest, P., Schwalb, J., & Aiyer, R. (2022). Balloon Kyphoplasty vs Vertebroplasty: A Systematic Review of Height Restoration in Osteoporotic Vertebral Compression Fractures. Journal of pain research, 15, 1233–1245.
16. Sun, H., Lu, P. P., Liu, Y. J., Yang, X., Zhou, P. H., Shen, X. F., Sun, S. W., & Yang, H. (2016). Can Unilateral Kyphoplasty Replace Bilateral Kyphoplasty in Treatment of Osteoporotic Vertebral Compression Fractures? A Systematic Review and Meta-analysis. Pain physician, 19(8), 551– 563.
17. Takahashi, S., Hoshino, M., Terai, H., Toyoda, H., Suzuki, A., Tamai, K., Watanabe, K., Tsujio, T., Yasuda, H., Kono, H., Sasaoka, R., Dohzono, S., Hayashi, K., Ohyama, S., Hori, Y., & Nakamura, H. (2018). Differences in short-term clinical and radiological outcomes depending on timing of balloon kyphoplasty for painful osteoporotic vertebral fracture. Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 23(1), 51–56.
18. Tsoumakidou, G., Too, C. W., Koch, G., Caudrelier, J., Cazzato, R. L., Garnon, J., & Gangi, A. (2017). CIRSE Guidelines on Percutaneous Vertebral Augmentation. Cardiovascular and interventional radiology, 40(3), 331–342.
19. Venmans, A., Klazen, C. A., Lohle, P. N., Mali, W. P., & van Rooij, W. J. (2012). Natural history of pain in patients with conservatively treated osteoporotic vertebral compression fractures: results from VERTOS II. AJNR. American journal of neuroradiology, 33(3), 519–521.
20. Wright, N. C., Looker, A. C., Saag, K. G., Curtis, J. R., Delzell, E. S., Randall, S., & Dawson-Hughes, B. (2014). The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 29(11), 2520–2526.
21. Zhan, Y., Jiang, J., Liao, H., Tan, H., & Yang, K. (2017). Risk Factors for Cement Leakage After Vertebroplasty or Kyphoplasty: A Meta-Analysis of Published Evidence. World neurosurgery, 101, 633–642.
22. Zhang, H., Xu, C., Zhang, T., Gao, Z., & Zhang, T. (2017). Does Percutaneous Vertebroplasty or Balloon Kyphoplasty for Osteoporotic Vertebral Compression Fractures Increase the Incidence of New Vertebral Fractures? A Meta-Analysis. Pain physician, 20(1), E13–E28.