European Spine Journal (2018) 27:1664
Answer to the Letter to the Editor of M. Ganau et al.
concerning “Osteoporotic thoracolumbar compression fractures:
long‑term retrospective comparison between vertebroplasty
and conservative treatment” by K. Martikos et al. [Eur Spine J (2018)
Received: 5 May 2018 / Accepted: 20 May 2018 / Published online: 6 June 2018
© Springer-Verlag GmbH Germany, part of Springer Nature 2018
We would like to thank the readers for the interest in our
manuscript and answer their questions as follows:
Regarding choice of treatment, each patient was evalu-
ated individually considering general health and the need
for early ambulation. All patients were informed of both
treatments, and ﬁnal decision was made considering both
patients’ preference and general health conditions.
In all cases, initial intention for VP was unilateral; there-
fore, initial approach was always unilateral. When PMMA
diﬀusion was not symmetrical within the vertebral body, a
contralateral approach was performed during the same surgi-
cal procedure in order to obtain a more symmetric augmen-
tation. The objective of our study takes into consideration
mainly long-term outcomes; the only early postoperative
data that were collected were PMMA complications. There-
fore, our study does not intend to argue with early beneﬁcial
eﬀects of PV.
Regarding our data that sustain a higher long-term adja-
cent fracture rate in patients treated with PV, we admit that
in every study there may be numerous statistical methods
for a more detailed analysis, but on the other hand there are
numerous studies reporting higher adjacent fracture rate in
patients treated with PV.
Regarding future fracture prevention, we fully agree that
medical treatment for osteoporosis and appropriate lifestyle
are very important; therefore, all patients admitted in our
Institute with osteoporotic fractures receive appropriate eval-
uation for adequate treatment with anti-osteoporotic drugs
after orthopedic treatment (CT or PV that may be).
Compliance with ethical standards
Conflict of interest No conﬂict of interest.
* Konstantinos Martikos
Spinal Deformities Division, Istituto Ortopedico Rizzoli, Via
Pupilli 1, 40136 Bologna, Italy