Mini Review

The effect of kyphoplasty and vertebroplasty on denosumab discontinuation rebound fractures

Paraskevas-Asimakis Velitsikakis^1,2, Stylianos Kopanos³, Georgios Giovanidis^1,2, Aikaterini Manta², Christos Zafeiris⁴

1. Postgraduate Program “Metabolic Bone Diseases”, National and Kapodistrian University of Athens, Medical School, Athens, Greece
2. Orthopaedic Department, General Hospital of Chalkida, Chalkida, Greece
3. Fellow Researcher, Second Gynaecological and Obstetrics Department, Aretaieion Hospital, Athens, Greece
4. Laboratory for the Research of the Musculoskeletal System “Th. Garofalidis”, National and Kapodistrian University of Athens, Medical School, Athens, Greece

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Keywords: Kyphoplasty, Vertebroplasty, Denosumab, Rebound fractures

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Abstract

Denosumab is an antiresorptive agent that significantly reduces bone turnover markers, increases mineral density and as a result, decreases the risk of vertebral fractures. The drug holiday effect on denosumab is associated with a high risk of multiple vertebrae fractures soon after the withdrawal. Discontinuation reasons may vary, but common reasons are the patient’s will, discontinuation due to an upcoming dental procedure and long treatment period. Treatment of these fractures can be either surgical augmentation or conservative with the use of antiresorptive drugs. The purpose of this scientific paper is to review current data on the effect of either kyphoplasty or vertebroplasty on these types of fractures. Several studies showed that surgical augmentation is associated with a higher risk of multiple vertebrae fractures in comparison with conservative treatment and thus, it is not recommended, though more research is needed.

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