Kyphoplasty: A Comprehensive Review of Procedural Techniques, Patient Selection, and Clinical Outcomes in the Treatment of Vertebral Compression Fractures
Abstract
Kyphoplasty is a minimally-invasive surgical technique designed to restore vertebral body height and reduce the associated kyphotic deformity. This intervention is typically performed following unsuccessful conservative therapy. Kyphoplasty must be conducted in the prone position under C-arm fluoroscopic guidance and usually employs local anesthetic techniques by trained practitioners. The procedure involves the percutaneous insertion of an inflatable balloon tamp within the fractured vertebral body in order to restore vertebral height, followed by the injection of polymethyl methacrylate (PMMA) bone cement to stabilize the fracture and increase vertebral stiffness by over 50%. Kyphoplasty is a practical therapeutic option for treating painful vertebral compression fractures (VCFs), considering its typically minor and infrequent complications. This study aims to review the best procedural techniques, as well as appropriate patient selection, to achieve the optimal outcome.
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4. Mattie R, Laimi K, Yu S, Saltychev M. Comparing Percutaneous Vertebroplasty and Conservative Therapy for Treating Osteoporotic Compression Fractures in the Thoracic and Lumbar Spine: A Systematic Review and Meta-Analysis. J Bone Joint Surg Am. 2016;98(12):1041-51. doi: 10.2106/jbjs.15.00425. [PubMed: 27307365].
5. Patel D, Liu J, Ebraheim NA. Managements of osteoporotic vertebral compression fractures: A narrative review. World J Orthop. 2022;13(6):564-73. doi: 10.5312/wjo.v13.i6.564. [PubMed: 35949707]. [PubMed Central: PMC9244957].
6. Zuo XH, Zhu XP, Bao HG, Xu CJ, Chen H, Gao XZ, et al. Network meta-analysis of percutaneous vertebroplasty, percutaneous kyphoplasty, nerve block, and conservative treatment for nonsurgery options of acute/subacute and chronic osteoporotic vertebral compression fractures (OVCFs) in short-term and long-term effects. Medicine (Baltimore). 2018;97(29):e11544. doi: 10.1097/md.0000000000011544. [PubMed: 30024546]. [PubMed Central: PMC6086478].
7. Liu D, Wen T, Li X, Xie Z, Wei M, Wang Y, et al. Percutaneous Vertebroplasty Versus Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures: Evaluating
the Overlapping Meta-analyses. Pain Physician. 2024;27(4):E383-e94. [PubMed: 38805534].
8. Margetis K, Patel A, Petrone B, Carter KR. Percutaneous Vertebroplasty and Kyphoplasty. StatPearls. Treasure Island, FL: StatPearls Publishing; 2026.
9. Armsen N, Boszczyk B. Vertebro-/Kyphoplasty History, Development, Results. Eur J Trauma. 2005;31(5):433-41. doi: 10.1007/s00068-005-2103-z.
10. Vincent SA, Gannon EJ, Moore DK. Kyphoplasty Techniques. In: Cheng BC, Editor. Handbook of Spine Technology. Cham, Switzerland: Springer International Publishing; 2021. p. 573-91.
11. Health Quality Ontario. Vertebral Augmentation Involving Vertebroplasty or Kyphoplasty for Cancer-Related Vertebral Compression Fractures: A Systematic Review. Ont Health Technol Assess Ser. 2016;16(11):1-202. [PubMed: 27298655]. [PubMed Central: PMC4902848].
12. Cerny J, Soukup J, Petrosian K, Loukotova L, Novotny T. Efficacy and Complication Rates of Percutaneous Vertebroplasty and Kyphoplasty in the Treatment of Vertebral Compression Fractures: A Retrospective Analysis of 280 Patients. J Clin Med. 2024;13(5):1495. doi: 10.3390/jcm13051495. [PubMed: 38592338]. [PubMed Central: PMC10933847].
13. Berenson J, Pflugmacher R, Jarzem P, Zonder J, Schechtman K, Tillman JB, et al. Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer: a multicentre, randomised controlled trial. Lancet Oncol. 2011;12(3):225-35. doi: 10.1016/s1470-2045(11)70008-0. [PubMed: 21333599].
14. Xu Z, Hao D, Dong L, Yan L, He B. Surgical options for symptomatic old osteoporotic vertebral compression fractures: A retrospective study of 238 cases. BMC Surg. 2021;21(1):22. doi: 10.1186/s12893-020-01013-1. [PubMed: 33407356]. [PubMed Central: PMC7789173].
15. Alpantaki K, Dohm M, Korovessis P, Hadjipavlou AG. Surgical options for osteoporotic vertebral compression fractures complicated with spinal deformity and neurologic deficit. Injury. 2018;49(2):261-71. doi: 10.1016/j.injury.2017.11.008. [PubMed: 29150315].
16. Garfin SR, Yuan HA, Reiley MA. New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine (Phila Pa 1976). 2001;26(14):1511-5. doi: 10.1097/00007632-200107150-00002. [PubMed: 11462078].
17. Sarli M, Pérez Manghi FC, Gallo R, Zanchetta JR. The vacuum cleft sign: an uncommon radiological sign. Osteoporos Int. 2005;16(10):1210-4. doi: 10.1007/s00198-005-1833-4. [PubMed: 15731885].
18. Wu AM, Chi YL, Ni WF. Vertebral compression fracture with intravertebral vacuum cleft sign: pathogenesis, image, and surgical intervention. Asian Spine J. 2013;7(2):148-55. doi: 10.4184/asj.2013.7.2.148. [PubMed: 23741556]. [PubMed Central: PMC3669703].
19. Momomura R, Shimamura Y, Kaneko K. Postoperative Clinical Outcomes of Balloon Kyphoplasty Treatment: Would Adherence to Indications and Contraindications Prevent Complications? Asian Spine J. 2020;14(2):198-203. doi: 10.31616/asj.2019.0010. [PubMed: 31679326]. [PubMed Central: PMC7113476].
20. Röllinghoff M, Zarghooni K, Schlüter-Brust K, Sobottke R, Schlegel U, Eysel P, et al. Indications and contraindications for vertebroplasty and kyphoplasty. Arch Orthop Trauma Surg. 2010;130(6):765-74. doi: 10.1007/s00402-010-1083-6. [PubMed: 20221618].
21. Telera S, Raus L, Pipola V, De Iure F, Gasbarrini A. Indications and Contraindication of Vertebroplasty and Kyphoplasty. In: Telera S, Raus L, Pipola V, De Iure F, Gasbarrini A, Editors. Vertebral Body Augmentation, Vertebroplasty and Kyphoplasty in Spine Surgery. Cham, Switzerland: Springer International Publishing; 2021. p. 47-67.
22. ChenC, FanP, XieX, WangY. Risk Factors for Cement Leakage and Adjacent Vertebral Fractures in Kyphoplasty for Osteoporotic Vertebral Fractures. Clin Spine Surg. 2020;33(6):E251-e5. doi: 10.1097/bsd.0000000000000928. [PubMed: 32011354].
23. Bednar T, Heyde CE, Bednar G, Nguyen D, Volpi E, Przkora R. Kyphoplasty for vertebral augmentation in the elderly with osteoporotic vertebral compression fractures: scenarios and review of recent studies. Clin Ther. 2013;35(11):1721-7. doi: 10.1016/j.clinthera.2013.09.016. [PubMed: 24139093]. [PubMed Central: PMC4172397].
24. Spenkelink IM, Heidkamp J, Fütterer JJ, Rovers MM. Image- guided procedures in the hybrid operating room: A systematic scoping review. PLoS One. 2022;17(4):e0266341. doi: 10.1371/journal.pone.0266341. [PubMed: 35363811]. [PubMed Central: PMC8975112].
25. Teriitehau C, Rabeh H, Pessis E, Sénéchal Q, Besse F, Bravetti M. Reduction of patient radiation dose during percutaneous CT vertebroplasty: Impact of a new computer-assisted navigation (CAN) system. Radioprotection. 2020;55(1):11-6. doi: 10.1051/radiopro/2019049.
26. RidgePC,CullivanS,CampbellCD,O'ReganA,RutherfordRM. Unusual case of preoperative hypoxaemia. Thorax. 2020;75(3):290-1. doi: 10.1136/thoraxjnl-2019-213473. [PubMed: 31907201].27. Bhave A. Vertebroplasty for Special Situations. In: Bhave A, Editor. Vertebroplasty Made Easy. Delhi, India: Jaypee Brothers Medical Publishers Ltd; 2008.
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| Files | ||
| Issue | Vol 12 No 3 (2026) | |
| Section | Review Article | |
| Keywords | ||
| Kyphoplasty Compression Fractures Osteoporosis Polymethyl Methacrylate Minimally Invasive Surgery Bone Cements | ||
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How to Cite
1.
Mousavi SM, Rahimian A. Kyphoplasty: A Comprehensive Review of Procedural Techniques, Patient Selection, and Clinical Outcomes in the Treatment of Vertebral Compression Fractures. J Orthop Spine Trauma. 2026;12(3):112-8.
