Balloon kyphoplasty in patients with osteoporotic vertebral compression fractures

Abstract

Balloon kyphoplasty (BKP) is a minimally invasive surgical procedure indicated for treatment of painful vertebral compression fractures. During BKP, cannulae are placed percutaneously into the vertebral body, allowing insertion of inflatable balloons. Inflating the balloons partially restores vertebral body height, compacts the bone and creates a cavity for placement of bone cement after balloon removal. Placement of the cement reduces and stabilizes the fracture. BKP differs from vertebroplasty in that it aims to restore vertebral height and reduce kyphotic deformity. Case reports and observational studies have consistently shown that BKP significantly reduces pain, increases mobility and functional capacity and improves quality of life for up to 3 years. Clinically significant adverse events have been rarely reported. These findings were confirmed in randomized and nonrandomized prospective controlled studies. The objective of this review is to describe the surgical procedures involved in BKP and to review the evidence supporting its use.

Keywords::

• balloon kyphoplasty
• instrumentation
• minimally invasive surgery
• osteoporosis
• osteoporotic fracture
• pain management
• vertebral compression fracture

Financial & competing interests disclosure

D Wardlaw has received honoraria for consulting from Medtronic Spine LLC and Cryolife. He has received research funding from Medtronic Spine LLC, Zimmer, Apatec and Cryolife. J Van Meirhaeghe has received honoraria for consulting from Medtronic Spine LLC and Synthes. J Ranstam is employed by the Swedish National Competence Centre for musculoskeletal disorders at Lund University Hospital, Sweden, an organization that has received compensation for work by Medtronic Spine LLC. L Bastian has received honoraria for consulting from Medtronic Spine LLC. S Boonen is senior clinical investigator of the Fund for Scientific Research (FWO_Vlaanderen) and holder of the Leuven University Chair in Gerontology and Geriatrics. He has received honoraria for consulting from Kyphon and Medtronic Spine LLC. He has received research funding or grant support from Amgen, Eli Lilly, Kyphon, Medtronic Spine LLC, Merck, Novartis, Procter and Gamble, Sanofi -Aventis, Servier and Roche–GlaxoSmithKline. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

The authors would like to thank Mary G Royer, a paid consultant of Medtronic BRC, for providing writing assistance in the preparation of this manuscript.