Division of Gerontology and Geriatrics and Center for Musculoskeletal Research, Department of Experimental Medicine, Leuven University, Leuven, Belgium.
Osteoporos Int. 2011 Dec;22(12):2915-34. doi: 10.1007/s00198-011-1639-5. Epub 2011 Jul 26.
Vertebral compression fractures (VCFs) are the most prevalent fractures in osteoporotic patients. The classical conservative management of these fractures is through rest, pain medication, bracing and muscle relaxants. The aim of this paper is to review prospective controlled studies comparing the efficacy and safety of minimally invasive techniques for vertebral augmentation, vertebroplasty (VP) and balloon kyphoplasty (BKP), versus non-surgical management (NSM). The Fracture Working Group of the International Osteoporosis Foundation conducted a literature search and developed a review paper on VP and BKP. The results presented for the direct management of osteoporotic VCFs focused on clinical outcomes of these three different procedures, including reduction in pain, improvement of function and mobility, vertebral height restoration and decrease in spinal curvature (kyphosis). Overall, VP and BKP are generally safe procedures that provide quicker pain relief, mobility recovery and in some cases vertebral height restoration than conventional conservative medical treatment, at least in the short term. However, the long-term benefits and safety in terms of risk of subsequent vertebral fractures have not been clearly demonstrated and further prospective randomized studies are needed with standards for reporting. Referral physicians should be aware of VP/BKP and their potential to reduce the health impairment of patients with VCFs. However, VP and BKP are not substitutes for appropriate evaluation and treatment of osteoporosis to reduce the risk of future fractures.
椎体压缩性骨折（VCFs）是骨质疏松症患者中最常见的骨折类型。这些骨折的经典保守治疗方法是通过休息、止痛药物、支具和肌肉松弛剂。本文旨在回顾比较微创椎体强化技术（经皮椎体成形术[VP]和球囊扩张椎体后凸成形术[BKP]）与非手术治疗（NSM）在治疗椎体压缩性骨折方面的疗效和安全性的前瞻性对照研究。国际骨质疏松基金会骨折工作组进行了文献检索，并撰写了一篇关于 VP 和 BKP 的综述文章。直接治疗骨质疏松性 VCF 的研究结果侧重于这三种不同手术程序的临床结果，包括疼痛减轻、功能和活动能力改善、椎体高度恢复以及脊柱曲度（后凸）减小。总体而言，VP 和 BKP 是一般安全的手术，与传统的保守药物治疗相比，至少在短期内能更快地缓解疼痛、恢复活动能力，在某些情况下还能恢复椎体高度。然而，在随后发生椎体骨折的风险方面，其长期获益和安全性尚未得到明确证实，需要进一步进行前瞻性随机研究，并制定报告标准。转诊医生应该了解 VP/BKP 及其减轻 VCF 患者健康损害的潜力。然而，VP 和 BKP 不能替代适当的骨质疏松评估和治疗，以降低未来骨折的风险。
