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Treatment of Spine Compression Fractures

In This Video

  • Vertebral augmentation is a technique in which fractures in the spine are stabilized by inserting cement into the spine. In the U.S., the technique is used with vulnerable patients whose fractures would not heal otherwise
  • Joshua Hirsch, MD, an interventional radiologist at Massachusetts General Hospital, and colleagues have reported on the benefits of vertebral augmentation relative to non-surgical management
  • In one study, they found a 55% survival benefit for patients who underwent vertebral augmentation

Joshua A. Hirsch, MD, vice-chair and service line chief of Neurointerventional Radiology, discusses treating compression fractures with vertebral augmentation at Massachusetts General Hospital.


I'm a neurointerventionalist by trade and I spend most of my clinical time working on spine disease.

I do a lot of work with vertebral augmentation. That's where you take cement and put it in the spine to stabilize fractures. In our country, we do that specifically for vulnerable patients that wouldn't otherwise heal on their own.

I would say some of the most important work we've done recently relates to looking at mortality and how mortality plays in both patients that are treated conservatively—non-surgical management—or with kyphoplasty, the techniques we utilize.

We found across the 10 years that we studied that, at every single time point, mortality was dramatically different between the kyphoplasty cohort and the non-surgical management cohort. Why is this important? Because the differences were spectacular: in one year—a 55% survival benefit for patients that underwent augmentation.

The mortality data has become a critical element in defining what the future I think of augmentation is. Because if there really is this large difference, which is biologically plausible, is it appropriate to withhold consultation for a patient?

I'm pleased to say, here at Mass General, we don't think so. We see lots of patients, we counsel them, we think about whether conservative therapy is most appropriate versus what we would consider surgical therapy or kyphoplasty.

Learn about Interventional Radiology at Mass General

Refer a patient to the Department of Radiology

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In a series of papers published over the past several years, Massachusetts General Hospital's Joshua Hirsch, MD, and colleagues have shown that vertebral augmentation offers significant benefits with respect to mortality.


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