Several studies have shown the benefit of VA versus conservative treatment in acute osteoporotic VCF [23,108,115-117], with benefits persisting through 1 year after intervention. However, others demonstrated that VA procedures might not affect global spinal alignment [118]. A meta-analysis found improvements in pain intensity, vertebral height, sagittal alignment, functional capacity, and quality of life with BK compared with conventional medical management [119]. Multiple other studies demonstrated the benefit of VA for alignment with improvement in pain relief [22,120-122] and respiratory function [89,123,124]. In a multisociety position statement, it was concluded that the VA of osteoporotic VCF is clearly beneficial in the short term and is likely beneficial in the long term [36]. Given the evidence that VA is more effective than prolonged medical treatment in achieving analgesia, improving function in patients with painful VCFs [117,125], and avoiding the complications of narcotic use, the threshold for performing VA has declined. Farrokhi et al [23] showed in a randomized control trial of percutaneous augmentation versus medical management for relief of pain and disability that the VA group had statistically significant improvements in pain and disability scores maintained over 24 months, improved vertebral body height restoration maintained over 36 months, and fewer adjacent level fractures compared to the medical management group. The timing of when VA is useful has been debated. Studies found VA to be superior to placebo intervention for pain reduction in patients with acute osteoporotic VCF of <6 weeks duration [22]. In a study by Syed et al [33], patients with VCFs >12 weeks compared to those patients with VCFs <12 weeks had equivalent benefit, suggesting that the age of the fracture does not independently affect the outcomes of VA.
Management of Vertebral Compression Fractures PCAs. Several studies have shown the benefit of VA versus conservative treatment in acute osteoporotic VCF [23,108,115-117], with benefits persisting through 1 year after intervention. However, others demonstrated that VA procedures might not affect global spinal alignment [118]. A meta-analysis found improvements in pain intensity, vertebral height, sagittal alignment, functional capacity, and quality of life with BK compared with conventional medical management [119]. Multiple other studies demonstrated the benefit of VA for alignment with improvement in pain relief [22,120-122] and respiratory function [89,123,124]. In a multisociety position statement, it was concluded that the VA of osteoporotic VCF is clearly beneficial in the short term and is likely beneficial in the long term [36]. Given the evidence that VA is more effective than prolonged medical treatment in achieving analgesia, improving function in patients with painful VCFs [117,125], and avoiding the complications of narcotic use, the threshold for performing VA has declined. Farrokhi et al [23] showed in a randomized control trial of percutaneous augmentation versus medical management for relief of pain and disability that the VA group had statistically significant improvements in pain and disability scores maintained over 24 months, improved vertebral body height restoration maintained over 36 months, and fewer adjacent level fractures compared to the medical management group. The timing of when VA is useful has been debated. Studies found VA to be superior to placebo intervention for pain reduction in patients with acute osteoporotic VCF of <6 weeks duration [22]. In a study by Syed et al [33], patients with VCFs >12 weeks compared to those patients with VCFs <12 weeks had equivalent benefit, suggesting that the age of the fracture does not independently affect the outcomes of VA.