Osteoporosis, Vertebral Compression Fractures, and Vertebral Cement Augmentation

At present, it is estimated that osteoporosis affects 10 million older adults in the United States, 80% of whom are women. In addition, there are a further 18 million individuals living with osteopenia. Worldwide, approximately 9 million fractures occur as a direct result of osteoporosis. The most common locations of these fragility fractures include the hip, distal radius, and vertebral body in the thoracic and lumbar spine. The lifetime risk of an osteoporotic fracture is between 30% and 40% in the developed world for women and about 10–15% for men. Osteoporosis in and of itself is not a surgical condition and can be treated with a variety of medical interventions ranging from calcium and vitamin D supplementation to disease-modulating agents. Nonoperative treatment is the preferred course of care for most VCFs. Immediate treatment centers around analgesia and activity modification. Bracing may be used as an adjunct for pain control. Operative intervention is used sparingly for VCFs. Open surgical procedures are reserved for cases of neurologic compromise, frank instability in the setting of a VCF, or severe deformity. There is, however, a more widely accepted role for cement augmentation.