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About 15 years ago, there was a wave of enthusiasm for doing vertebral augmentation (vertebroplasty or kyphoplasty) in patients with acute or subacute vertebral fractures. That enthusiasm waned after several randomized trials showed minimal or no benefit, but the procedure still is performed in some practices. One controversy is whether vertebral augmentation increases risk of a new “secondary” fracture in adjacent vertebrae — a finding in one of the randomized vertebroplasty trials. An osteoporosis treatment guideline explicitly expresses concern about this potential complication (Endocr Pract 2020; 26 [Suppl 1]:1). One theory is that vertebral augmentation might affect biomechanics in the adjacent spine adversely.
To revisit the question o…