Severe Pain. Vertebroplasty is commonly used following failure of conservative care such as bed rest, bracing, physicial therapy or adverse effect of medication. If the pain intensity is severe following the above care, vertebroplasty is a good alternative. It may be used immediately in those patient whose pain is so intensive that hospitalization is required and in the elderly who cannot tollerate bed rest.
Controversial. These procedures can improve the pain on osteoporosis related compression fractures in the elderly. Unfortunately, they can also increase the risk of adjacent level fractures in these patients. Hence, I suggest patients try bracing before these procedures. If the bracing is not effective for pain control, then these procedures can certainly help with pain control.