Diagnosis and Management of Osteoporotic Vertebral Compression Fractures.

J Bone Joint Surg Am · Mar 04 2026 · Review

Daher M, Sebaaly A, Sakr I, Daniels AH, Schoenfeld AJ

Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Massachusetts

Spine Orthopaedic Trauma

SUMMARY — THE REDUCTIONThis review outlines diagnosis and management of osteoporotic vertebral compression fractures, favoring conservative care first-line and noting kyphoplasty's advantage over vertebroplasty for reducing kyphosis and adjacent fractures.
Abstract, as published

➢ The incidence of vertebral compression fractures is increasing, particularly in elderly populations and postmenopausal women, in whom low bone mineral density is a key underlying factor.➢ Conservative management remains the first-line treatment option due to its high success rate and avoidance of surgical complications. When surgical intervention is necessary, cement augmentation via kyphoplasty and via vertebroplasty remain the most common options.➢ Kyphoplasty may be favored over vertebroplasty, especially in patients with severe preoperative kyphotic deformities, as kyphoplasty has a lower risk of adjacent vertebral fractures and demonstrates a greater reduction of the kyphotic deformity.➢ Consideration of restoring proper local spinal alignment is essential in preventing adjacent vertebral fractures and maintaining long-term spinal stability.

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