Percutaneous vertebroplasty is widely used for low-energy vertebral compression fractures, but its clinical benefits remain debated. Studies and meta-analyses have reported mixed results, while complications occur in a significant proportion of patients, highlighting the importance of careful patient selection. To standardize management, a clinical decision tree was developed based on patient age, MRI findings, pain severity (VAS), and radiological deformity.
Age > 50 years
One or more low-energy vertebral compression fractures (LEVCFs) confirmed by MRI
Fractures located between T7 and L5
Compression fractures classified as A1.1, A1.2, or A1.3 according to the Magerl classification [15]
Pregnant or breastfeeding women
Individuals under administrative or judicial supervision
Age < 50 years or > 90 years
Pathological vertebral fracture