Prospective clinical follow-up after percutaneous vertebroplasty in patients with painful osteoporotic vertebral compression fractures

J Vasc Interv Radiol. 2006 Aug;17(8):1313-20. doi: 10.1097/01.RVI.0000231952.75209.4A.

Abstract

Purpose: To prospectively assess short-term, midterm, and long-term pain relief in patients with painful osteoporotic vertebral compression fractures (VCFs) treated with percutaneous vertebroplasty (PV).

Materials and methods: Visual analog scale (VAS) scores for pain at the treated vertebral level, analgesic use, and satisfaction with outcome were assessed in 112 patients after PV of 168 VCFs. Serial follow-up was performed at 24 hours and 3, 6, and 12 months and in a small number of patients at 1-3 years. Procedure-related complications were evaluated by physical examination and computed tomography of treated levels.

Results: After PV, VAS scores for pain at the individual vertebral levels treated and use of analgesic agents were significantly reduced compared with before treatment at every follow-up period. Within 24 hours after the procedure, the decreases in all scores were less compared with scores at later follow-up periods, but this was not significant. The preprocedural mean VAS score was 8.8 (range, 5-10). At follow-up, mean VAS scores ranged from 2.5 to 3.3 (range, 0-10). In the short term after PV, patients used significantly less analgesic drugs and 86% of patients were satisfied with the outcome. At midterm and long-term follow-up, patients used even less analgesic drugs and 95%-100% of patients were satisfied with the outcome of PV. Procedure-related complications with clinical consequences occurred in three patients (2.7%): one patient experienced a cardiovascular reaction, one patient had a pedicle chip fracture, and one had a rib fracture.

Conclusion: PV of painful osteoporotic VCFs provides significant pain reduction in nearly all treated patients.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analgesics / therapeutic use
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Follow-Up Studies
  • Fractures, Compression / diagnostic imaging
  • Fractures, Compression / etiology
  • Fractures, Compression / therapy*
  • Humans
  • Injections, Spinal
  • Male
  • Middle Aged
  • Osteoporosis / complications
  • Osteoporosis / diagnostic imaging
  • Osteoporosis / therapy*
  • Pain / etiology
  • Pain Management*
  • Pain Measurement
  • Polymethyl Methacrylate / administration & dosage
  • Polymethyl Methacrylate / therapeutic use*
  • Prospective Studies
  • Radiography, Interventional
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / etiology
  • Spinal Fractures / therapy*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Analgesics
  • Polymethyl Methacrylate