Objective: To determine the effectiveness and safety of percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures as published in the scientific literature.
Design: Literature review.
Method: Medline and the Cochrane library were searched with the terms 'percutaneous vertebroplasty', 'vertebral compression fractures', 'osteoporotic' and 'osteoporosis'. Criteria for inclusion were: (a) the studies had to have been published in the period January 1985-August 2002, (b) the study population had to include at least 10 patients, (c) the patients had to have been treated with percutaneous vertebroplasty, and (d) the diagnosis had to have been 'osteoporotic vertebral compression fracture'.
Results: Twelve studies met the inclusion criteria. Pain relief was seen in 60%-100% of the patients within the first 24 hours and this result improved to 78-100% in the long term (maximum 4 years). The complications immediately after the procedure were related to cement leakages and were mostly of no clinical consequence. Serious complications such as pulmonary embolism were rare. In the long term, percutaneous vertebroplasty was associated with an increased risk of fractures in the adjacent vertebrae.
Conclusion: Percutaneous vertebroplasty seems to be effective and safe in the treatment of osteoporotic vertebral compression fractures. A prospective randomised intervention study has, however, not yet been performed. For the time being, percutaneous vertebroplasty should be reserved for carefully selected patients in whom conservative therapy has not produced results.