Via practica 6/2010

Surgical treatment of osteoporotic vertebra fractures

Osteoporosis is a metabolic disease of a bone, which causes getting thinner of a bone and an increased risk of spontaneous fracture of vertebrae. It is prevalent mostly in women of higher age. Clinically osteoporotic fractures present with pain and kyphotization of the affected segment. Diagnosis is made by x-ray and densitometry. Non-operative, conservative treatment includes using of drugs affecting metabolism of calcium, bed-rest and mobilisation with corset. In past, options of surgical treatment were limited because of their aggressiveness. Nowadays we dispose with minimally invasive techniques such as percutaneous vertebroplasty, which principle consist in percutaneous application of slowly solidifying cement into the fractured vertebra to stop further collapse and alleviate local pain and balloon kyphoplasty, when we not only stabilise the vertebra, but with this technique we reconstruct the height of the vertebra. Clinical results show outstanding decrease in pain in the affected segment and decrease of complications due to subsequent kyphosis. In Slovakia, both techniques are covered by insurance companies and are well available on selected departments, but number of treated patients is markedly lower than in adjacent countries.

Keywords: osteoporosis, osteoporotic compressive fracture of vertebra, percutaneous vertebroplasty, balloon kyphoplasty