Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb;7(1):71-82.
doi: 10.1055/s-0036-1583288. Epub 2017 Feb 1.

Spinal Compression Fracture Management: A Review of Current Treatment Strategies and Possible Future Avenues

Free PMC article

Spinal Compression Fracture Management: A Review of Current Treatment Strategies and Possible Future Avenues

Ivo K Genev et al. Global Spine J. .
Free PMC article


Study design: Narrative review.

Objective: Despite the numerous treatment options for vertebral compression fractures, a consensus opinion for the management of patients with these factures has not been established. This review is meant to provide an up-to-date overview of the most common treatment strategies for compression fractures and to suggest possible routes for the development of clearer treatment guidelines.

Methods: A comprehensive database search of PubMed was performed. All results from the past 30 years were obtained and evaluated based on title and abstract. The full length of relevant studies was analyzed for level of evidence, and the strongest studies were used in this review.

Results: The major treatment strategies for patients with compression fractures are conservative pain management and vertebral augmentation. Despite potential adverse effects, medical management, including nonsteroidal anti-inflammatory drugs, calcitonin, teriparatide, and bisphosphonates, remains the first-line therapy for patients. Evidence suggests that vertebral augmentation, especially some of the newer procedures, have the potential to dramatically reduce pain and improve quality of life. At this time, balloon-assisted kyphoplasty is the procedure with the most evidence of support.

Conclusions: Based on current literature, it is evident that there is a lack of standard of care for patients with vertebral compression fractures, which is either due to lack of evidence that a procedure is successful or due to serious adverse effects encountered with prolonged treatment. For a consensus to be reached, prospective clinical trials need to be formulated with potential new biomarkers to assess efficacy of treatment strategies.

Keywords: finite element analysis; kyphoplasty; pain management; spinal compression fracture; vertebral augmentation; vertebroplasty.

Similar articles

See all similar articles

Cited by 1 article


    1. Riggs BL, Melton LJ., III The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 1995;17(5, Suppl):505S–511S - PubMed
    1. Mazanec DJ, Podichetty VK, Mompoint A, Potnis A. Vertebral compression fractures: manage aggressively to prevent sequelae. Cleve Clin J Med 2003;70(2):147–156 - PubMed
    1. Ensrud KE, Schousboe JT. Clinical practice. Vertebral fractures. N Engl J Med 2011;364(17):1634–1642 - PubMed
    1. McConnell CT, Jr, Wippold FJ, II, Ray CE, Jr, et al. ACR appropriateness criteria management of vertebral compression fractures. J Am Coll Radiol 2014;11(8):757–763 - PubMed
    1. Esses SI, McGuire R, Jenkins J, et al. The treatment of symptomatic osteoporotic spinal compression fractures. J Am Acad Orthop Surg 2011;19(3):176–182 - PubMed

LinkOut - more resources