Purpose of Technology: Percutaneous kyphoplasty (KP) is an interventional procedure used to treat painful vertebral compression fractures related to osteoporosis. The procedure involves guided insertion of an inflatable bone tamp into the partially collapsed vertebral body. Once in place, the balloon is expanded to the desired height and removed. An acrylic polymer is then injected into the space, where it hardens and binds to the vertebral body.

Rationale: KP is intended to relieve pain, stabilize the bone, prevent additional fractures, and potentially restore vertebral height.

Controversy: Evidence suggests that vertebral augmentation procedures, including KP and vertebroplasty (VP), may provide superior outcomes to conservative treatment for patients with painful vertebral compression fractures (VCFs). However, 2 studies published in 2009 suggest that VP provides similar outcomes to sham treatment. Further, randomized trials consistently show similar efficacy and safety profiles for KP and VP. Utilization of both procedures has dropped in recent years, VP more so than KP. Compounding the controversy, recent evidence suggests that KP may be associated with lower mortality compared with VP. While the clinical and technical significance of these findings are not understood, continued scrutiny of these procedures may be warranted.

Relevant Questions:

  • Is KP effective for relieving pain and improving functionality and quality of life (QOL) in patients with osteoporotic VCFs (OVCFs)?
  • Is KP safe for patients with OVCFs?
  • How does KP compare with conservative treatment, VP, and/or sham?
  • Have definitive patient selection criteria been established for KP?

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