Minimally invasive treatment of osteoporotic vertebral compression fracture.
BACKGROUND
The use of percutaneous vertebroplasty (PV) to treat osteoporotic vertebral fractures is increasing. This investigation assesses the efficacy and safety of PV for refractory pain owing to osteoporotic vertebral compression fractures.


METHODS
A retrospective investigation of PV was conducted with a minimal of 1 year follow up. PV with polymethylmethacrylate (PMMA) was performed on 75 patients with osteoporotic vertebral compression fractures that responded poorly to the conservative therapy. Patients were asked to quantify their degree of pain using Huskisson's visual analogue scale to assess the clinical results.


RESULTS
Eighty-seven vertebrae treated using PV in 70 patients were evaluated with a minimal of 1 year follow up. Pain, as assessed on the VAS, decreased from 80+/-16 mm before PV to 36+/-28 mm at 1 month after PV and 30+/-19 mm at the most recent follow up. The reduction in pain from the baseline to 1 month (p=0.031) and to final follow up (p=0.023) were both statistically significant. Sixty-two patients (85.5%) quickly returned to their pre-injury activity level and achieved better quality of life.


CONCLUSIONS
PV is effective in pain reduction for painful vertebral compression fractures. It provided significant pain relief. Skillful techniques and careful safeguards can minimize the risks of PMMA migration.
Chen
Lih-Huei
LH
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taipei. lhchen2132@cgmh.org.tw
Niu
Chi-Chien
CC
Yu
Shang-Won
SW
Fu
Tsai-Sheng
TS
Lai
Po-Liang
PL
Chen
Wen-Jer
WJ
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D019637:Orthopedic Procedures / Q000379:methods*; D010024:Osteoporosis / Q000150:complications*; D019904:Polymethyl Methacrylate; D012189:Retrospective Studies; D013117:Spinal Cord Compression; D016103:Spinal Fractures / Q000601:surgery*; D013131:Spine / Q000601:surgery*
D019904:Polymethyl Methacrylate