Disclosures: Vinny Francio, MD: No financial relationships or conflicts of interest

Objective: To assess the effectiveness of PVP/BK in reducing pain and improving MSK function in elderly patients with radiological evidence of VF, in comparison to NST alone. VFs are caused by trauma, osteoporosis, or neoplasia, and are associated with substantial morbidity and mortality, but clinical management remains controversial. Therefore, proper treatment selection criteria for NST versus procedures is essential.

Design: Narrative review of MEDLINE manuscripts within the past decade. 10 studies were fully reviewed and included of the 98 total. Setting : N/A Participants : N/A

Interventions: N/A

Main Outcome Measures: N/A

Results: A 2016 meta-analysis reviewed 10 RCTs discussing PVP/BK versus NST for VFs. PVP/BK resulted in more pain relief and higher QoL. A 2018 review compared PVP/BK versus NST and showed that ODI scores were better for BK/PVP compared to NST. In 2019 a meta-analysis compared NST with PVP showed reduced pain, ODI, and RMDQ scores with PVP. The comparative efficacy of BK/PVP was similar for all. A 2019 meta-analysis revealed that PVP had the highest probability of being the most effective for pain, ODI, and RMDQ. BK had the highest probability of improving SF-36 scores and reducing the risk of subsequent VFs/re-fractures. A 2019 meta-analysis discussed a comparison between PVP and NST suggesting that PVP/BK has benefits on pain relief at 1 week, 1 month and resulted in higher QoL. Conclusions: The results of multiple studies from the past decade seem to favor the use of PVP/BK in VFs to improve pain, QoL, disability, when compared to NST. Overall, BK/PVP are safe and effective procedures with level I evidence. Since VFs have been associated with increased morbidity and mortality, multiple medical societies favor and confidently advocate its use, when the procedure is performed by well-trained physicians, and when proper patient selection criteria are utilized. Although most VFs are managed with NST, a subset (40%) warrant safe and effective PVP/BK procedures.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/is-percutaneous-vertebroplasty-balloon-kyphoplasty-superior-to-non-surgical-conservative-treatment-to-reduce-pain-and-improve-function-in-elderly-patients-with-vertebral-fracture-a-narrative-review/