Vertebral augmentation: Vertebroplasty and kyphoplasty

Vertebroplasty and kyphoplasty are minimally invasive vertebral augmentation procedures that involve percutaneous image-guided injection of cement into the vertebral body. In general, most are performed for symptomatic vertebral fractures that fail conservative management. Augmentation is also common for symptomatic neoplastic fractures, osteolytic metastasis, symptomatic neoplasm, or vascular tumor. The definition of failure of conservative management is variable, but it generally is considered to have occurred when pain persists at a level that severely compromises the patient's mobility or activities of daily living despite a reasonable therapeutic trial of analgesic therapy, or if such therapy produces unacceptable side effects, such as excessive sedation or confusion from the level of analgesia required to maintain the pain at a tolerable level.