Percutaneous vertebroplasty for pain relief and spinal stabilization.
METHODS
This was a retrospective review of 47 consecutive patients (1995-1998) in whom percutaneous intraosseous methylmethacrylate cement injection (percutaneous vertebroplasty) was used to treat osteoporotic vertebral compression fractures and spinal column neoplasms.


OBJECTIVE
To present initial results regarding pain relief, spinal stabilization, and complications after treatment with percutaneous vertebroplasty.


BACKGROUND
Percutaneous vertebroplasty was developed in France in the late 1980s. Several European reports have described excellent results for treatment of compression fractures and neoplasms. The procedure was not performed in the United States until 1994. Only a single series of 29 patients treated in the United States has been reported.


METHODS
A retrospective review was conducted of 47 consecutive patients with 84 vertebrae treated with percutaneous vertebroplasty. Thirty-eight patients with 70 vertebrae had symptomatic, osteoporotic fractures and had failed medical therapy. Eight patients with 13 vertebrae had primary or metastatic neoplasms. One patient had a hemangioma. Immediate and long-term pain response, spinal stability, and complications were evaluated.


RESULTS
Among the 38 patients treated for osteoporotic fractures, 24 (63%) had marked to complete pain relief, 12 (32%) moderate relief and 2 (5%) no significant change. Only 4 of the 8 patients with malignancies had significant pain relief. In 7 of these patients, no further vertebral compression occurred, and spinal canal compromise was prevented. The patient with the hemangioma had no significant pain reduction. Minor complications occurred in 3 (6%) patients.


CONCLUSIONS
Percutaneous vertebroplasty provided significant pain relief in a high percentage of patients with osteoporotic fractures. The procedure provided spinal stabilization in patients with malignancies but did not produce consistent pain relief. Complications were minor and infrequent. Percutaneous vertebroplasty is a promising therapy for patients with osteoporotic fractures and for selected vertebral column neoplasms.
Barr
J D
JD
Cleveland Clinic Foundation, Divisions of Radiology and Surgery, Cleveland, Ohio, USA. barrj@ccf.org
Barr
M S
MS
Lemley
T J
TJ
McCann
R M
RM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001843:Bone Cements; D005260:Female; D005598:Fractures, Spontaneous / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D019637:Orthopedic Procedures / Q000379:methods*; D010024:Osteoporosis / Q000150:complications / Q000000981:diagnostic imaging; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D001843:Bone Cements