Corticosteroid-induced osteoporosis is the most common cause of drug-related osteoporosis and appears frequently in the patients affected from rheumatoid arthritis with high rate of pathological vertebral compression fractures (VCFs). The consequences of VCFs include pain related to the fracture and spinal kyphosis. The aim of treatment of osteoporosis is to halt bone loss, to reduce pain and to prevent the occurrence of future fractures through osteoinduction. The treatment of osteoporotic VCFs ideally should address both the fracture-related pain and associated spinal deformity. Balloon kyphoplasty entails the insertion and expansion of an inflatable bone tamps (IBT) in a fractured vertebral body. Bone cement is then deposited into the cavity created by the IBT to reduce the kyphosis and repair the fracture. Twenty-nine corticosteroid-induced osteoporotic VCFs were treated during 21 balloon kyphoplasty procedures in 17 patients. Standing radiographs centered on the treated level/s obtained prekyphoplasty and postkyphoplasty were analysed for improvement in sagittal alignment using the Cobb technique. The clinical outcomes were assessed according to visual analogue scale with 0 representing no pain and 10 severe pain. Patients rated their pain before surgery, 1 week after surgery and at 1 year-postoperative period. Mean improvement in local sagittal alignment was 11.3° (range 0°–32°). All of the patients who had reached the 1-year postoperative period had reported a high reduction in pain, with 11 patients reporting no pain whatsoever. Corticosteroid-induced osteoporotic VCFs present a significant economic burden to society and result in severe clinical consequences leading to impaired function, reduced pulmonary function and overall increase in mortality. Traditional medical option including bed rest, bracing and analgesics have proven to be insufficient. Patients with rheumatoid arthritis treated with kyphoplasty in combination with pharmacologic therapy return to higher activity levels, leading to increased independence and quality of life.

Purpose: Lumbar interbody fusion cages is a valid technique in the treatment of disc diseases. The aim of this study is to evaluate its validity through the analysis of clinical outcomes and radiological findings.

Materials and methods: The paper reports a serie of 52 posterior lumbar interbody fusion cages operations. Clinical outcomes and radiological results were evaluated at a mean of 5 years post-surgery.

Results: Outcome analysis showed a gradual improvement in symptoms. After surgery, the majority of patients returned to their normal activities. Follow-up plain roentgenograms showed no loss of disc height and no signs of implant’s looseness. Computed Tomography (CT) scans showed the presence of mineralized autologous bone grafts inside the interbody cages.

Conclusions: Expandable interbody cages allow the restoration of the disc space height, giving support to the anterior column, opening the neuroforaminal area and providing increased stability. The interpretation of fusion on the basis of roentgenograms is subjected to arguement. Thin CT scan offers more information than X-rays about the fusion process.