Calcium phosphate cement-based vertebroplasty compared with conservative treatment for osteoporotic compression fractures: a matched case-control study.
OBJECTIVE
Few studies have been conducted to compare vertebroplasty and conservative treatment for osteoporotic vertebral compression fractures (OVCFs). To investigate the effects of calcium phosphate cement (CPC)-based vertebroplasty on relief of pain and augmentation of the fractured vertebral body (VB), the authors compared the results of CPC-assisted vertebroplasty with those of conservative treatment alone.


METHODS
Two groups of patients were examined: the vertebroplasty group (30 consecutive patients with primary OVCF) and the control group (30 patients matched for age, sex, interval from injury to treatment, and grade of the posterior wall defects of the fractured VB). Outcome measures included the visual analog scale (VAS) score of back pain and analgesic requirements, and the radiographically documented rate of the VB kyphosis. The follow-up duration was more than 12 months (mean 17 months). The mean VAS score at 12 months after injury was 0.67 cm in the vertebroplasty group and 1.97 cm in the control group, and the mean improvement rates in the VAS scores were 91.6 and 73.6%, respectively (p < 0.0001). The mean duration of analgesic requirement was 8.3 days in the vertebroplasty group and 62.2 days in the control group (p = 0.0005). The mean kyphosis rate at 12 months after injury was 72.9% in the vertebroplasty group and 58% in the control group, and the mean recovery rate of kyphosis was +8.4 and -21%, respectively (p < 0.0001).


CONCLUSIONS
The authors conclude that CPC-assisted vertebroplasty provides better clinical and radiological results than conservative treatment for primary OVCF.
Nakano
Masato
M
Department of Orthopaedic Surgery, Toyama Rosai Hospital, Japan. mnakano-tym@umin.ac.jp
Hirano
Norikazu
N
Ishihara
Hirokazu
H
Kawaguchi
Yoshiharu
Y
Watanabe
Hiroki
H
Matsuura
Kousou
K
D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain; D001843:Bone Cements; D002130:Calcium Phosphates / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D050815:Fractures, Compression / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010024:Osteoporosis / Q000150:complications*; D010147:Pain Measurement; D019651:Plastic Surgery Procedures / Q000379:methods*; D013131:Spine / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
D001843:Bone Cements; D002130:Calcium Phosphates; C020243:calcium phosphate