Extrapedicular approach of percutaneous vertebroplasty in the treatment of upper and mid-thoracic vertebral compression fracture.
OBJECTIVE
To evaluate the clinical outcome of the extrapedicular approach of percutaneous vertebroplasty (PVP) for upper and mid-thoracic vertebral compression fractures in patients.


METHODS
Extrapedicular vertebroplasty was performed in painful compression fractures at T4-T8 levels. The assessment criteria were changes over time in visual analog scale (VAS) and mobility score. We evaluated the volume of cement injected, the size of needle required, and complications.


RESULTS
Procedures were performed in 27 patients with a total of 34 affected vertebral bodies. Early (within a week) and one year later, clinical follow-ups showed that pain intensity had decreased by 50% one day after operation and later by 70-80%. Mobility scores of all patients were improved immediately after the procedure. Average volume of polymethylmethacrylate (PMMA) per vertebral body was 3.8 +/- 1.2 ml. Leakage of PMMA occurred in one vertebral level (intradiskal space), but did not cause clinical complications.


CONCLUSIONS
PVP of upper and mid-thoracic spine with an extrapedicular approach is an efficient and safe procedure for treating painful thoracic vertebral compression fracture under a cautious patient selection and meticulous technical procedure.
Pain Clinic, Department of Anesthesiology and Pain Medicine, Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
K R
KR
Han
C
C
Kim
J S
JS
Eun
Y S
YS
Chung
D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000601:surgery*; D001843:Bone Cements / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007278:Injections, Spinal / Q000379:methods; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000187:drug effects; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D019904:Polymethyl Methacrylate / Q000009:adverse effects / Q000627:therapeutic use*; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery*; D016896:Treatment Outcome
D001843:Bone Cements; D019904:Polymethyl Methacrylate