The Treatment of Symptomatic Osteoporotic Spinal Compression Fractures

J Am Acad Orthop Surg. 2011 Mar;19(3):176-82. doi: 10.5435/00124635-201103000-00007.


This clinical practice guideline is based on a series of systematic reviews of published studies on the treatment of symptomatic osteoporotic spinal compression fractures. Of 11 recommendations, one is strong; one, moderate; three, weak; and six, inconclusive. The strong recommendation is against the use of vertebroplasty to treat the fractures; the moderate recommendation is for the use of calcitonin for 4 weeks following the onset of fracture. The weak recommendations address the use of ibandronate and strontium ranelate to prevent additional symptomatic fractures, the use of L2 nerve root blocks to treat the pain associated with L3 or L4 fractures, and the use of kyphoplasty to treat symptomatic fractures in patients who are neurologically intact.

Publication types

  • Practice Guideline

MeSH terms

  • Bone Density Conservation Agents / therapeutic use
  • Calcitonin / therapeutic use
  • Combined Modality Therapy
  • Diphosphonates / therapeutic use
  • Evidence-Based Medicine
  • Fractures, Compression / therapy*
  • Humans
  • Ibandronic Acid
  • Nerve Block
  • Organometallic Compounds / therapeutic use
  • Osteoporotic Fractures / therapy*
  • Pain Measurement
  • Spinal Fractures / therapy*
  • Thiophenes / therapeutic use
  • Vertebroplasty / methods


  • Bone Density Conservation Agents
  • Diphosphonates
  • Organometallic Compounds
  • Thiophenes
  • strontium ranelate
  • Calcitonin
  • Ibandronic Acid