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It is the position of the American Society of Interventional and Therapeutic Neuroradiology, Society of Interventional Radiology, American Association of Neurological Surgeons/Congress of Neurological Surgeons, and American Society of Spine Radiology (‘the Societies’) that percutaneous vertebral augmentation with vertebroplasty and kyphoplasty is a safe, efficacious, and durable procedure in appropriate patients with symptomatic osteoporotic and neoplastic fractures when performed in a manner in accordance with published standards.1 2 These procedures are offered only when traditional medical therapy has not provided pain relief or pain is substantially altering the patient's lifestyle. With regard to vertebroplasty, multiple case series3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 and retrospective18 19 and prospective20 21 22 23 non-randomized studies have shown a statistically significant improvement in pain and function—particularly with regard to ambulation—and these results have been confirmed in a prospective study with use of a control group24 and in a prospective randomized control study.25 The benefits of vertebroplasty far outweigh its risks and the risks of conservative therapy, and the success rate is consistently high. This procedure is cost-effective because it produces immediate improvement in a patient's quality of life, primarily by means of the alleviation of pain and rapid return to ambulation. In addition to reducing the need for costly skilled care, expensive drugs, or orthopedic devices, a return to ambulation is known to reduce adverse outcomes in elderly patients confined to bed.26
Kyphoplasty has been introduced as an alternative approach.27 It is similar to vertebroplasty and has been referred to as ‘balloon-assisted vertebroplasty.’ Kyphoplasty entails the inflation of a percutaneously delivered balloon in the vertebral body followed by the percutaneous injection of bone cement into the cavity created by the balloon. The balloon is intended to restore …
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