JBJS - 2026-03-04 - Journal Article; Review
Diagnosis and Management of Osteoporotic Vertebral Compression Fractures.
Daher M, Sebaaly A, Sakr I, Daniels AH, Schoenfeld AJ
Topics
Key Takeaway
Kyphoplasty demonstrates lower adjacent vertebral fracture risk and greater kyphotic deformity correction compared to vertebroplasty, particularly in patients with severe preoperative kyphosis.
Summary Depth
Choose how much analysis to show on this article page.
Summary
This narrative review addresses diagnosis and management of osteoporotic vertebral compression fractures, synthesizing evidence on conservative care, vertebroplasty, and kyphoplasty. Conservative management is endorsed as first-line given high success rates and avoidance of procedural complications. When cement augmentation is indicated, kyphoplasty is favored over vertebroplasty for superior kyphosis correction and reduced adjacent-level fracture risk.
Key Limitation
As a narrative review without meta-analytic methodology, no pooled effect sizes or heterogeneity assessments are provided, making it impossible to quantify the magnitude of kyphoplasty's advantage over vertebroplasty.
Original Abstract
➢ The incidence of vertebral compression fractures is increasing, particularly in elderly populations and postmenopausal women, in whom low bone mineral density is a key underlying factor.➢ Conservative management remains the first-line treatment option due to its high success rate and avoidance of surgical complications. When surgical intervention is necessary, cement augmentation via kyphoplasty and via vertebroplasty remain the most common options.➢ Kyphoplasty may be favored over vertebroplasty, especially in patients with severe preoperative kyphotic deformities, as kyphoplasty has a lower risk of adjacent vertebral fractures and demonstrates a greater reduction of the kyphotic deformity.➢ Consideration of restoring proper local spinal alignment is essential in preventing adjacent vertebral fractures and maintaining long-term spinal stability.