Vertebral augmentation has been one of my favorite spine treatments since I performed my first case in 1994 and saw the incredibly good and immediate results. This was done under the aegis of Dr. John Mathis, who published the last comprehensive work on vertebral augmentation in 2006. Fourteen years later, we have seen significant advancements in techniques, literature, and augmentation devices and all of these topics have been covered in this book.
What we know now about the treatment of vertebral compression fractures (VCFs) that we didn’t know a decade ago is that treating these fractures with augmentation is demonstrably life-saving and life-prolonging and is one of the very few things we do in medicine that attains this benchmark. To break it down to a personal level for those practitioners performing vertebral augmentation, the number of patients needed to treat (statistically called the NNT) to save 1 life at 1 year is only 15 patients and, on the average, additional life expectancy of each treated patient will be between 2 and 7 years.
In my own practice centered on the treatment of painful spine conditions, vertebral augmentation produces the best results of anything we do with an average pain score that decreased from 9/10 to 1.4/10 in our patients at the first post-treatment visit in the largest post-market trial done to date. The transition of technologies from vertebroplasty to intravertebral implants has given new dimensions and made significant improvements in pain as well as greater anatomic restoration and fewer subsequent fractures.
This book is designed to be a comprehensive guide and has certainly accomplished that by discussing all aspects of vertebral augmentation including the history, techniques, approaches, troubleshooting, implant augmentation, pre-procedure and post-procedure assessments, osteoporosis treatment, fill material, and augmentation outside of the spine. One of the chapters is written by the global masters of vertebral augmentation that includes personal tips, tricks, and pearls they use in their own practices. We have also included conditions and concepts that were never before described in the medical literature. It has been a pleasure and a privilege to be involved in the writing of this book. I would like to thank all the associate editors, contributors, and all others who have made this work possible. From an amazing beginning of a transoral injection of bone cement into a painful benign tumor affecting the C2 vertebral body to today’s incredible advancements, vertebral augmentation just keeps getting better and better.
Douglas P. Beall, MD