Treatment of chronic symptomatic vertebral compression fractures with percutaneous vertebroplasty.
OBJECTIVE
Most fractures treated with percutaneous vertebroplasty are subacute and less than 1 year old. We report our experience treating chronic vertebral fractures with vertebroplasty.


METHODS
Our database identified 41 patients with symptomatic fractures more than 1 year old. These patients were categorized into subgroups determined by fracture age: 12 months 1 day-24 months (n = 16) or more than 24 months 1 day (n = 25). Changes in pain and mobility for the study group were compared with those in 49 patients with fractures less than 1 year old.


RESULTS
Thirty-three (80%) of the 41 patients in the study group had improvement in pain-seven (17%) had complete and 26 (63%) had partial relief. Forty-five (92%) of the 49 control group patients had improvement in pain-24 (49%) had complete and 21 (43%) had partial relief. The number of patients achieving partial or complete relief of pain was not statistically different between groups (p > 0.05), although complete relief was significantly more frequent in the control group (p = 0.002). Twenty patients (49%) in the study group versus 34 patients (69%) in the control group had improved mobility after vertebroplasty (p = 0.047). Patients with fractures 12 months 1 day-24 months old had improvement in mobility similar to that in patients in the control group (p = 0.962). Fractures more than 24 months 1 day old were associated with significantly less improvement in mobility (p = 0.006).


CONCLUSIONS
Most patients with fractures more than 1 year old will experience clinical benefit from vertebroplasty. Complete relief of pain is more likely when less mature fractures are treated.
Brown
Daniel B
DB
Mallinckrodt Institute of Radiology, 510 S Kingshighway Blvd, Box 8131, St Louis, MO 63110, USA. brownda@mir.wustl.edu
Gilula
Louis A
LA
Sehgal
Manu
M
Shimony
Joshua S
JS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000209:etiology / Q000628:therapy*; D001843:Bone Cements / Q000627:therapeutic use*; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D020366:Methylmethacrylate / Q000008:administration & dosage*; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications / Q000628:therapy*; D013904:Thoracic Vertebrae / Q000293:injuries*; D013997:Time Factors; D016896:Treatment Outcome
D001843:Bone Cements; D020366:Methylmethacrylate