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Journal of Neurosurgical Sciences 2022 August;66(4):311-26

DOI: 10.23736/S0390-5616.22.05642-9

Copyright © 2022 THE AUTHORS

This is an open access article distributed under the terms of the CC BY-NC 4.0 license which allows users to distribute, remix, adapt and build upon the manuscript, as long as this is not done for commercial purposes, the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI), provides a link to the license and indicates if changes were made.

lingua: Inglese

Vertebral augmentation in osteoporotic spine fractures: WFNS Spine Committee recommendations

Salman SHARIF 1 , Muhammad Y. ALI 1, Francesco COSTA 2, Mehmet ZILELI 3, Jutty PARTHIBAN 4

1 Department of Neurosurgery, Liaquat National Hospital and Medical College, Karachi, Pakistan; 2 Department of Neurosurgery, Humanitas University, Milan, Italy; 3 Department of Neurosurgery, Ege University, Izmir, Turkey; 4 Spine Unit, Department of Neurosurgery, Kovai Medical Center and Hospital, Coimbatore, India

INTRODUCTION: The aim of this study was to formulate the WFNS Spine Committee guidelines on indications, outcomes, and complications of vertebral augmentation in osteoporotic spine fractures.
EVIDENCE ACQUISITION: Computerized literature was searched from 2010 to 2021 using keywords “vertebral augmentation,” “osteoporotic fracture,” “technique,” “surgery,” “complication,” and “outcome.” PubMed yielded 92 articles whereas Google scholar resulted in 120 articles. 29 articles were studied in detail. The studies comprised of seventeen RCT’s, two prospective non-randomized studies, three retrospective studies, and seven systematic reviews. The statements were produced to reach a consensus in two separate meetings of WFNS Spine Committee. The statements were voted and reached a positive or negative consensus using Delphi method.
EVIDENCE SYNTHESIS: Drafted statements on “Vertebral Augmentation in osteoporotic Spine Fractures” were voted upon by expert panelists in Virtual WFNS Spine Committee Consensus Meetings conducted on January 11, 2021, and February 13, 2021. Statements reaching positive consensus provided the basis for the WFNS guidelines regarding vertebral augmentation in osteoporotic spine fractures.
CONCLUSIONS: WFNS Spine Committee recommendations on vertebral augmentation in osteoporotic spine fractures are summarized in this article. Vertebral augmentation is superior to conservative treatment for vertebral osteoporotic fractures but has conflicting results on comparison with placebo. Both vertebroplasty and kyphoplasty are equally effective. Most of the studies regarding the efficacy of vertebral augmentation procedures to reduce pain have been largely inconclusive. It is suggested that further high quality, better designed randomized controlled studies are required to establish the role of vertebral augmentation in spine osteoporotic compression fractures.

KEY WORDS: Spine; Osteoporotic fractures; Vertebroplasty; Kyphoplasty; Conservative treatment

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