Is kyphoplasty (kyphoplasty) beneficial for older vertebral fractures?

From the Guidelines

Kyphoplasty can be beneficial for older vertebral fractures, particularly in patients with cancer, as it provides immediate pain relief and improves functional status. The Cancer Patient Fracture Evaluation study, a randomized controlled trial, found that kyphoplasty significantly improved back-specific functional status and reduced pain in patients with cancer and painful vertebral compression fractures 1. The study demonstrated a mean change in Roland-Morris disability questionnaire (RDQ) score of 8.3 points in the kyphoplasty group compared to 0.1 points in the control group at 1 month.

When considering kyphoplasty for older vertebral fractures, several factors should be taken into account, including:

• The patient's overall health and presence of any underlying conditions, such as cancer
• The severity and location of the pain
• The presence of any biomechanical changes or muscle fatigue that may be contributing to the pain
• The patient's functional limitations and ability to perform daily activities
• The failure of conservative management, including pain medications, bracing, and physical therapy

In general, kyphoplasty may be more beneficial for patients with:

• Localized pain directly corresponding to the fracture level on imaging
• Failed conservative management
• Significant functional limitations due to pain
• Presence of cancer or other underlying conditions that may be contributing to the fracture

However, the benefits of kyphoplasty for older vertebral fractures may be more limited and less predictable compared to acute fractures, and the decision to proceed with the procedure should be individualized based on the patient's specific circumstances. The role of kyphoplasty in the management of painful vertebral compression fractures, particularly in patients with cancer, is supported by the evidence, but further investigation is needed to fully understand its benefits and limitations 1.

From the Research

Kyphoplasty for Older Vertebral Fractures

• Kyphoplasty is a minimally invasive procedure used to treat vertebral compression fractures, which can provide significant pain relief and improvement in functional outcome 2.
• The procedure involves stabilizing the vertebral body and restoring spinal alignment, which can help to reduce pain and improve function 3, 4.
• Studies have shown that kyphoplasty can be effective in treating both acute and chronic vertebral compression fractures, with significant improvements in pain and function reported in patients who have undergone the procedure 5, 6.

Benefits of Kyphoplasty for Older Fractures

• Kyphoplasty can provide significant pain relief, with studies reporting improvements in visual analog scale (VAS) scores and Oswestry Disability Index (ODI) scores 2, 6.
• The procedure can also help to improve functional outcome, with patients reporting improvements in mobility and ability to perform daily activities 2, 6.
• Kyphoplasty may also help to reduce the risk of further fractures, by stabilizing the vertebral body and restoring spinal alignment 3, 4.

Considerations for Kyphoplasty in Older Fractures

• The decision to undergo kyphoplasty should be made on a case-by-case basis, taking into account the individual patient's medical history, fracture severity, and overall health status 3, 4.
• Patients with older fractures may still benefit from kyphoplasty, although the procedure may be less effective in reducing fracture severity and improving spinal alignment compared to acute fractures 6.
• As with any medical procedure, there are potential risks and complications associated with kyphoplasty, including cement leakage and nerve damage 3, 4.