Relevance of antecedent venography in percutaneous vertebroplasty for the treatment of osteoporotic compression fractures.
OBJECTIVE
Controversy exists regarding the utility of antecedent venography in percutaneous vertebroplasty. Our purpose was to determine whether antecedent venography improves clinical outcomes and/or decreases extravertebral cement extravasation in these procedures.


METHODS
We retrospective reviewed outcomes of consecutive percutaneous vertebroplasty procedures performed at our institution to define two populations, each consisting of 24 patients treated at 42 vertebral levels. Group 1 included patients who underwent antecedent venography, and group 2 included patients treated without venography. Clinical outcomes were assessed with quantitative measurements of pain and mobility. Venograms and postprocedural radiographs were interpreted to evaluate the number of vertebrae with extravertebral cement extravasation, degree of extravasation at each level, and correlation between venography and vertebroplasty.


RESULTS
Pain improved in 19 of 20 group 1 patients, compared with 21 of 22 group 2 patients; mean postoperative pain levels were 1.3 and 1.8, respectively (P =.50), on a scale of 0 (no pain) to 10 (worst pain). All 11 group 1 patients with impaired preoperative mobility reported postoperative improvement, as did all 12 group 2 patients; mean levels of postoperative impaired mobility for groups 1 and 2 were 0.35 and 0.27, respectively (P =.43). Twenty-two of 42 vertebrae treated in group 1 demonstrated extravasation, compared with 28 of 42 in group 2 (P =.266); amounts of extravasation did not differ. Among 22 levels of extravasation in group 1, venograms in 14 showed correlative extravasation.


CONCLUSIONS
Antecedent venography does not significantly improve the effectiveness or safety of percutaneous vertebroplasty performed by qualified, experienced operators.
Gaughen
John R
JR
Department of Radiology, University of Virginia Health Services, Charlottesville 22908, USA.
Jensen
Mary E
ME
Schweickert
Patricia A
PA
Kaufmann
Timothy J
TJ
Marx
William F
WF
Kallmes
David F
DF
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001843:Bone Cements / Q000627:therapeutic use*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000517:prevention & control; D005260:Female; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D010147:Pain Measurement; D010690:Phlebography; D019904:Polymethyl Methacrylate / Q000008:administration & dosage / Q000627:therapeutic use*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D013131:Spine / Q000098:blood supply*
D001843:Bone Cements; D019904:Polymethyl Methacrylate