Percutaneous vertebroplasty immediately relieves pain of osteoporotic vertebral compression fractures and prevents prolonged immobilization of patients.
To assess the immediate efficacy of percutaneous vertebroplasty (PVP) in relief of pain and improving mobility of patients with vertebral compression fractures (VCF) secondary to osteoporosis, 205 cases (175 patients) underwent 250 percutaneous injections of polymethylmethacrylate (PMMA; unilateral, 247 levels; bilateral, 3 levels) into vertebrae under CT and fluoroscopic guidance for 34 months. Patients were prospectively asked to quantify their pain on a visual analog scale (VAS) before and a day after PVP. The interval to mobilization was recorded in those who were immobilized because of pain and/or bed-rest therapy (115 cases). PVP was technically successful in all patients, with three cases of minimal complications. The mean VAS score available for 196 cases was improved from 7.22+/-1.89 (range, 3-10) to 2.07+/-1.19 (range, 0-10) by PVP. Ninety-four of 115 immobilized cases (81.7%) were mobile by 24 h after PVP, and the mean value was 1.9+/-2.8 days. The incidence of recurrent and new fractures was 15.6% in 4-25 months (mean, 15.3 months). PVP is a safe and effective treatment for relieving the pain associated with osteoporotic VCF and strengthening the vertebrae, avoiding refractures. This therapy leads to early mobilization and avoidance of the dangers of conservative therapy of bed-rest.
Kobayashi
Kiyokazu
K
Department of Radiology, Kyoto Renaiss Hospital, 1-38 Suehiro-cho, Fukuchiyama, Kyoto, 620-0054, Japan. radiology@renaiss.jp
Shimoyama
Keiji
K
Nakamura
Keiya
K
Murata
Kiyoshi
K
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007103:Immobilization; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement; D018579:Patient Selection; D019904:Polymethyl Methacrylate / Q000627:therapeutic use*; D015641:Radiography, Interventional; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D019904:Polymethyl Methacrylate