• Michael E Frey.
• Virginia Commonwealth University, Richmond, VA, USA. mfreymd@comcast.net
• Pain Physician. 2009 May 1;12(3):645-9.

AbstractOsteoporosis is a metabolic disorder which may result in devastating medical problems if not treated appropriately. However, even in the best treated patients fractures may occur. The most devastating fractures are spine and hip. Traditionally, treating fractures of the spine consisted of bed rest, opioid analgesic medications, and bracing. This resulted in increased risk of side-effects from medication, myocardial infarction, pulmonary embolism, pneumonia, admissions to nursing homes, and death. Vertebroplasty and kyphoplasty techniques were developed to decrease the detrimental effects of "conservative care" by decreasing or eliminating the pain and stabilizing the fracture. The safety and efficacy of vertebroplasty and kyphoplasty are similar with several biased opinions in the literature which denotes conflict. Choosing one technique over the other is a physician and/or facility performed preference. There are a small percentage of patients that either vertebroplasty or kyphoplasty does not help. Possibilities could be that not enough cement was used, an adjacent level fracture has occurred, or worsening fracture around the previously treated fracture is causing the pain. For the latter, a repeat vertebral augmentation could be medically necessary. Due to technical constraints, placing an additional kyphoplasty after one has already been accomplished may be technically dangerous and a simpler less costly vertebroplasty technique may be beneficial. This is a case report and review of the literature on the treatment of repeat vertebral augmentation after a previously treated vertebral fracture with kyphoplasty technique. To this date, this is the first article published regarding the use of vertebroplasty technique over a kyphoplasty treated patient. In this case report, a redo vertebroplasty was performed over a previously treated kyphoplasty or vertebroplasty. This procedure can give a patient significant pain relief when they are suffering with pain after a previously treated fracture.

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