NICE has published final guidance recommending two treatments – vertebroplasty and kyphoplasty – for fractured bones in the vertebrae caused by osteoporosis.
The new guidance says that percutaneous vertebroplasty and percutaneous balloon kyphoplasty are recommended as options for treating osteoporotic vertebral compression fractures in people who have severe ongoing pain after a recent, unhealed vertebral fracture despite optimal pain management and in those whom the pain has been confirmed to be at the level of the fracture by physical examination and imaging. Vertebral compression fractures due to osteoporosis can cause the spine to become curved and can also cause loss of height. This may result in pain, difficulties in breathing, gastrointestinal problems and disturbed sleep. Symptomatic fractures are also associated with an increase in mortality, because of the impact on health from difficulties in eating, breathing and moving about. Vertebroplasty involves injecting bone cement into the solid part of the vertebra, to provide pain relief for people with painful fractures and to strengthen the bone to prevent future fractures. Kyphoplasty without stenting is a variation of vertebroplasty involving inserting a balloon-like device into the solid part of the vertebra and slowly inflating it until it restores the normal height of the bone. When the balloon is deflated, the space is filled with bone cement. Kyphoplasty aims to reduce curvature of the spine.
