CLINICAL AND BIOMECHANICAL ASPECTS OF VERTEBROPLASTY AND KYPHOPLASTY IN THE MANAGEMENT OF VERTEBRAL COMPRESSION FRACTURES

Abstract

Vertebral compression fractures represent a major clinical problem, particularly in elderly patients with osteoporosis, malignancies, or metabolic bone disease. Minimally invasive vertebral augmentation techniques, including vertebroplasty and kyphoplasty, have been widely adopted for pain control and mechanical stabilization of fractured vertebral bodies. The present article reviews and analyzes the clinical outcomes, biomechanical principles, complication profiles, and material-related aspects of vertebroplasty and kyphoplasty. Special attention is paid to cement viscosity, injection pressure, cement distribution, and their influence on spinal biomechanics and adjacent-level fracture risk. The mechanisms of pain relief, including mechanical stabilization, chemical effects of bone cement, and thermal factors, are critically discussed. Published clinical data demonstrate significant pain reduction in up to 90% of patients following vertebral augmentation, with kyphoplasty offering additional benefits in terms of controlled cement delivery and partial restoration of vertebral body height. However, cement leakage, adjacent vertebral fractures, and unresolved questions regarding optimal material selection remain important challenges. Further prospective and biomechanical studies are required to optimize patient selection, procedural techniques, and biomaterials for vertebral augmentation.