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J Am Coll Radiol 2018 Nov;15(11S):S347-S364

Specialty Chair (Neurological), UC San Diego Health, San Diego, California.

Vertebral compression fractures (VCFs) have various causes, including osteoporosis, neoplasms, and acute trauma. As painful VCFs may contribute to general physical deconditioning, management of painful VCFs has the potential for improving quality of life and preventing superimposed medical complications. Various imaging modalities can be used to evaluate a VCF to help determine the etiology and guide intervention. Read More

Geriatr Orthop Surg Rehabil 2017 Mar 14;8(1):3-9. Epub 2016 Dec 14.

Department of Orthopedic, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany.

Introduction: Osteoporotic pelvic ring fractures are a rising problem for surgeons in industrialized countries. There is no evidence-based treatment strategy especially for lateral compression (LC) fractures involving the sacrum. The aim of this study was to evaluate and compare outcome and survival rate of nonoperative and operative treatment strategies for lateral compression fractures. Read More

J Long Term Eff Med Implants 2016 ;26(3):205-208

Division of Orthopaedic Surgery, Center for Evidence-Based Orthopaedics, McMaster University, 293 Wellington St. N., Suite 110, Hamilton, ON L8L 8E7, Canada.

Osteoporotic vertebral compression fractures affect more than 1 million patients worldwide each year. Percutaneous balloon kyphoplasty is a minimally invasive vertebral augmentation procedure that aims to stabilize fractured vertebral compression fractures rapidly and improve spinal deformity. The Fracture Reduction Evaluation (FREE) trial was the first randomized trial to compare balloon kyphoplasty against nonoperative management and it remains a landmark trial today. Read More

Neurosurgery 2015 Oct;77 Suppl 4:S33-45

*Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri; ‡The Center for Orthopedic Research and Education, Phoenix, Arizona; §Cleveland Clinic, Richard E. Jacobs Health Center, Cleveland, Ohio.

Vertebral compression fractures (VCFs) are the most common type of fracture secondary to osteoporosis. These fractures are associated with significant rates of morbidity and mortality and annual direct medical expenditures of more than $1 billion in the United States. Although many patients will respond favorably to nonsurgical care of their VCF, contemporary natural history data suggest that more than 40% of patients may fail to achieve significant pain relief within 12 months of symptom onset. Read More

Spine (Phila Pa 1976) 2015 Aug;40(15):1228-41

*Medtronic, Inc., Sunnyvale, CA †Exponent, Inc., Philadelphia, PA; and ‡Exponent, Inc., Menlo Park, CA. Dr. Edidin is a former employee of Medtronic.

Study Design: Vertebral compression fracture (VCF) patients in the 100% US Medicare data set (2005-2009).

Objective: To compare the mortality and morbidity risks for VCF patients undergoing conservative treatment (nonoperated), balloon kyphoplasty (BKP), and vertebroplasty (VP).

Summary Of Background Data: Studies have reported lower mortality risk for BKP or VP cohorts than nonoperated cohorts, but it is uncertain whether there are any differences in morbidity risks. Read More

J Bone Joint Surg Am 2014 Jul 2;96(13):e110. Epub 2014 Jul 2.

Department of Orthopedic Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. E-mail address for B.H. Lee: E-mail address for S. Lim: E-mail address for S.H. Moon: E-mail address for J.-O. Park: E-mail address for H.-S. Kim: E-mail address for H.-M. Lee:

Background: Falls are a major factor contributing to fragility fractures. Patients with lumbar spinal stenosis have an increased risk of falling. We are aware of no prior report demonstrating the effect of medical treatment and decompression surgery on the risk of patients with lumbar spinal stenosis falling. Read More

Neurosurg Focus 2014 ;37(1):E3

Departments of Neurosurgery and.

Traumatic fractures of the thoracolumbar spine are relatively common occurrences that can be a source of pain and disability. Similarly, osteoporotic vertebral fractures are also frequent events and represent a significant health issue specific to the elderly. Neurologically intact patients with traumatic thoracolumbar fractures can commonly be treated nonoperatively with bracing. Read More

Clin Orthop Relat Res 2010 Jul;468(7):1773-80

Department of Orthopaedic Surgery, Hahnemann University Hospital, Drexel University College of Medicine, 245 N 15th Street, Philadelphia, PA, 19102, USA.

Background: The majority of the 700,000 osteoporotic vertebral compression fractures (VCFs) that occur annually in the United States affect women. The total treatment costs exceed $17 billion and approximate the total costs of breast cancer ($13 billion) and heart disease ($19 billion). Balloon-assisted percutaneous vertebral augmentation with bone cement (kyphoplasty) reportedly reduces VCF-related pain and accelerates return of independent functional mobility. Read More

Rev Med Brux 2008 Sep;29(4):317-22

Service d'Orthopédie, Clinique du dos, C.H.U. Saint Pierre et Hôpital Erasme, Bruxelles.

Osteoporosis is a systemic disease and results in progressive bone mineral loss and concurrent change in bone architecture that leave bone vulnerable to fracture. In one third of patients with acute vertebral fracture, severe pain and limited mobility persist despite appropriate nonoperative management. Vertebroplasty is a minimally invasive method that involved the percutaneous injection of cement into a collapsed vertebral body to stabilize the fractured vertebra. Read More

Support Cancer Ther 2006 Jul;3(4):214-9

Department of Orthopaedic Surgery, Weill Medical College of Cornell University, Hospital for Special Surgery, New York.

As cancer survival rates continue to improve, many patients with cancer experience an increased incidence of osteolytic bone destruction that can lead to vertebral collapse. Many people with vertebral compression fractures develop pain and spinal deformity, mainly kyphosis. Kyphosis has been associated with a decrease in physical function, depression, loss of independence, decreased lung capacity, malnutrition because of early satiety, and death. Read More

Injury 2007 Sep;38 Suppl 3:S40-8

Section, Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Washington University, School of Medicine, Saint Louis, Missouri 63110, USA.

As the population ages, vertebral compression fractures are an increasing source of pain and dysfunction. The immobilisation that often occurs with fractures can lead to multiple medical complications and their management can be complex as care may require multiple treatment modalities. Each individual responds to pain differently and a treatment plan must be tailored to the individual's pain, functional limitations and goals. Read More

Spine J 2008 Sep-Oct;8(5):763-9. Epub 2007 Jul 18.

Department of Orthopedic Surgery, Albany Medical College, Albany, NY 12206, USA.

Background: A growing population of patients with osteoporosis and fragility fractures has developed. Fragility fractures, including vertebral compression fractures, have been associated with increased mortality. Early operative interventions for patients sustaining hip fractures have been found to reduce mortality. Read More

Am J Orthop (Belle Mead NJ) 2007 May;36(5):241-8

Department of Orthopaedic Surgery, New York University/Hospital for Joint Diseases, New York, New York 10003, USA.

Of the estimated 1.5 million osteoporosis-related fragility fractures that occur each year in the United States, vertebral compression fractures (VCFs) are the most common. It is estimated that approximately 20% to 25% of people who sustain a VCF have symptoms severe enough to seek medical attention. Read More

Osteoporos Int 2006 4;17(6):817-26. Epub 2006 Mar 4.

Cleveland Clinic Spine Institute and Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Cleveland, OH, USA.

Introduction: Vertebral body compression fractures secondary to osteoporosis or malignant osteolysis are an increasingly common problem. The primary purpose of our study was to assess functional outcomes of kyphoplasty for the treatment of osteoporotic and osteolytic vertebral compression fractures. Our secondary purpose was to compare such functional outcomes in patients with osteoporosis versus multiple myeloma. Read More

J Bone Joint Surg Am 2004 Dec;86-A(12):2600-6

Center for Bone Diseases, Marshfield Clinic, 1000 North Oak, Marshfield, WI 54449, USA.

Background: Percutaneous vertebroplasty may be indicated when a patient with a painful osteoporotic vertebral compression fracture remains intolerably symptomatic in spite of comprehensive, nonoperative management. Relief of pain and quality of life following percutaneous vertebroplasty, however, remain incompletely defined. We investigated these outcomes with use of a visual analog scale and a validated, osteoporosis-specific health-related quality-of-life instrument. Read More

J Orthop Trauma 2004 May-Jun;18(5):294-9

Charlotte Orthopedic Research Institute, an affiliate of Charlotte Orthopedic Specialists, Charlotte, NC 28207, USA.

Objectives: Document initial outcomes of balloon kyphoplasty.

Design: Retrospective analysis of the first 52 patients with 82 painful vertebral body compression fractures secondary to osteoporosis treated at our institution.

Setting: Operation on subacute painful fractures with office follow-up. Read More

Spine J 2004 Mar-Apr;4(2):218-29

The Rothman Institute and Jefferson Medical College, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107-4216, USA.

Background Context: With the aging of the population, painful osteoporotic compression fractures are becoming more common.

Purpose: To review the physiologic implications of these injuries as well as treatment options and outcomes, especially with reference to newer, percutaneous "augmentation" procedures, that is, vertebroplasty and kyphoplasty.

Study Design/setting: A literature review. Read More

J Spinal Disord Tech 2003 Feb;16(1):10-9

Department of Orthopaedic Surgery, Penn State-Hershey Medical Center, Pennsylvania 17033, USA.

A retrospective study was performed on the operative results following osteoporotic burst fractures with neurologic compromise. We sought to investigate the results of operative decompression and stabilization in patients with neurologic deficit as a result of an osteoporotic burst fractures. We examined the postoperative radiographic outcomes, level of disability, functional outcomes, and complications. Read More

Am J Orthop (Belle Mead NJ) 2000 Jan;29(1):45-7

Department of Orthopedic Surgery, University of Tennessee College of Medicine/ Chattanooga Unit, USA.

The present study is a retrospective review of the treatment of 12 humeral shaft nonunions by using an intramedullary allograft with compression plating. The average age of the patients was 61 years (range, 36-82 years). Eight cases involved the proximal shaft, 3 cases were at the mid-diaphyseal level, and 1 case was at the distal one third. Read More