Vertebroplasty and Kyphoplasty: Cement Augmentation Techniques

Vertebroplasty and kyphoplasty are key cement augmentation techniques used to treat painful osteoporotic spine fractures. These minimally invasive procedures stabilise weakened vertebrae and provide rapid pain relief.

In certain cases requiring spinal instrumentation, cement-augmented screws may also be used to improve fixation in osteoporotic bone.

These approaches aim to restore spinal stability, reduce the risk of further collapse, and support early return to mobility.

The Use of Cement Augmentation for Osteoporotic Spine Fractures

Osteoporosis is an extremely common metabolic disorder in our local population. It is characterized by low bone density which predisposes us to fractures. It typically occurs in the elderly and female gender due to hormonal changes. However, it may also occur in younger patients with other underlying conditions or on chronic medications such as steroids.

Fortunately, most of these osteoporotic fractures can be treated with conservative measures such as bracing, oral painkillers and medical treatment of the underlying osteoporosis.

On occasion, the fracture may display features of instability causing severe debilitating pain. It can fail to heal and gradually collapse and cause deformity. In severe cases, it may progress to, ironically, compress on the nerves which it aims to protect.

In such cases, cement augmentation techniques in which low viscosity cement is inserted into the bone, can be used to provide immediate mechanical support from within. These are minimally invasive procedures which can be performed under local anesthesia with sedation or general anesthesia.

Types of Cement Augmentation Techniques

Several cement augmentation techniques are available to stabilise osteoporotic spine fractures. The choice of technique depends on the fracture pattern, degree of collapse, and overall spinal stability.

Vertebroplasty

This is a minimally invasive surgery. One or two specialized needles are introduced into the fractured  bone under radiological guidance. The weakened bone is filled with cement to augment stability at the fracture site.

Kyphoplasty

This is a minimally invasive surgery. One or two specialized needles are introduced into the fractured  bone under radiological guidance. An inflatable balloon is expanded within the bone which elevates the collapse of the fracture, this also creates a cavity for the bone cement to be inserted under low pressure. The balloon is then deflated, and the weakened bone is filled with cement to augment stability at the fracture site.

Cement Augmented Screw Fixation

In cases where screws are required to stabilize osteoporotic bone. Specialized screws with fenestrations can be utilized. Cement is inserted via the central canal within the screw and is introduced into the bone via holes in the tips of the screw. This increases the holding strength of the screw which would otherwise be compromised by the poor bone quality.

Finding the Right Solution: Vertebroplasty, Kyphoplasty, or Screw Fixation?

Every spine fracture is unique, and selecting the most suitable treatment depends on factors like the severity of the fracture, your overall bone health, and symptoms. Vertebroplasty and kyphoplasty are minimally invasive options that provide quick pain relief and help stabilize weakened bones. Kyphoplasty also has the added benefit of restoring some height to collapsed vertebrae.

In some cases, when additional support is needed—especially if surgery involves placing screws in fragile bone—cement-augmented screw fixation may be recommended. This technique strengthens the hold of screws to ensure better spinal stability.

Your surgeon will carefully evaluate your condition and discuss these options to tailor the best treatment plan that balances safety, effectiveness, and your recovery goals.