Minimally invasive treatment of vertebral compression fractures

  Osteoporotic vertebral compression fractures often result in pain and limited mobility, especially as the incidence increases with the aging population. In recent years, the minimally invasive treatment of osteoporotic vertebral compression fractures by percutaneous vertebroplasty or retroconvective vertebroplasty, in which bone cement is injected into the vertebral body by percutaneous puncture or the compressed vertebral body is first propped up with a balloon and then cement is injected for vertebral strengthening, can achieve the purpose of stabilizing the fracture, restoring the mechanical strength of the vertebral body and relieving pain. In recent years, percutaneous vertebroplasty (PVP) and posterior kyphoplasty (PKP) have achieved good results in the minimally invasive treatment of osteoporotic compression fractures.  Treatment of osteoporotic compression fractures: Osteoporosis is a systemic disease characterized by decreased bone mass and degradation of bone microstructure, leading to increased bone fragility and susceptibility to fracture, most commonly in postmenopausal women and the elderly population. Due to a significant reduction in the biomechanical properties of the vertebral body, osteoporotic patients are prone to compression fractures when subjected to minor external forces. Only 25% of patients with osteoporotic compression fractures have a clear history of trauma and a 20% or 4 mm reduction in vertebral body height is considered a compression fracture. There are three types of osteoporotic compression fractures: wedge compression fractures, biconcave compression fractures and comminuted compression fractures, of which The most common type is the wedge compression fracture (51%). Only 23-33% of compression fracture patients present with clinical symptoms, mainly pain, progressive spinal collapse, and kyphotic deformity, which seriously affects patients’ quality of life, physical activity, mental health, and longevity. Traditional treatment with bed rest, pain medication, braces, and anti-osteoporosis drugs is less effective and often difficult to tolerate in the elderly, while surgical treatment is limited by the difficulty of internal fixation and poor fusion, and patients with compression fractures have a 5-25-fold increased risk of recurrence of compression fractures in adjacent vertebrae within a year. HerveDeramond carried out the first case of PVP and achieved satisfactory results in the treatment of cervical vertebral hemangioma by filling bone cement into the vertebral body through puncture, which was first reported in 1987, and the first use of PVP for osteoporotic compression fractures in North America in 1993 achieved satisfactory results and was first reported in 1997, and the first training course on PVP was held in 1998, and in 1998 PKP was used for the first time to treat osteoporotic compression fractures with satisfactory results and was first reported in 2000.  In October 2000, the Department of Orthopaedics of the PLA General Hospital was the first to carry out PKP for osteoporotic compression fractures in China, and since then many hospitals in China have carried out PVP and PKP for osteoporotic compression fractures. PVP and PKP have gradually become an effective minimally invasive treatment for osteoporotic compression fractures. With the continuous introduction and updating of new technologies and products, a balloon-expanded vertebroplasty surgical kit, which is clinically safer, more effective and less expensive to use, was marketed above the 2007 National Orthopaedic Annual Meeting held in Beijing in November 2006.