Prospective clinical follow-up after percutaneous vertebroplasty in patients with painful osteoporotic vertebral compression fractures.
OBJECTIVE
To prospectively assess short-term, midterm, and long-term pain relief in patients with painful osteoporotic vertebral compression fractures (VCFs) treated with percutaneous vertebroplasty (PV).


METHODS
Visual analog scale (VAS) scores for pain at the treated vertebral level, analgesic use, and satisfaction with outcome were assessed in 112 patients after PV of 168 VCFs. Serial follow-up was performed at 24 hours and 3, 6, and 12 months and in a small number of patients at 1-3 years. Procedure-related complications were evaluated by physical examination and computed tomography of treated levels.


RESULTS
After PV, VAS scores for pain at the individual vertebral levels treated and use of analgesic agents were significantly reduced compared with before treatment at every follow-up period. Within 24 hours after the procedure, the decreases in all scores were less compared with scores at later follow-up periods, but this was not significant. The preprocedural mean VAS score was 8.8 (range, 5-10). At follow-up, mean VAS scores ranged from 2.5 to 3.3 (range, 0-10). In the short term after PV, patients used significantly less analgesic drugs and 86% of patients were satisfied with the outcome. At midterm and long-term follow-up, patients used even less analgesic drugs and 95%-100% of patients were satisfied with the outcome of PV. Procedure-related complications with clinical consequences occurred in three patients (2.7%): one patient experienced a cardiovascular reaction, one patient had a pedicle chip fracture, and one had a rib fracture.


CONCLUSIONS
PV of painful osteoporotic VCFs provides significant pain reduction in nearly all treated patients.
Voormolen
Maurits H J
MH
Department of Radiology, St Elisabeth Ziekenhuis, P.O. Box 90151, 5000 LC Tilburg, The Netherlands. mhjvoorm@move.nl
Lohle
Paul N
PN
Lampmann
Leo E
LE
van den Wildenberg
Wilco
W
Juttmann
Job R
JR
Diekerhof
Carel H
CH
de Waal Malefijt
Jan
J
D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement; D019904:Polymethyl Methacrylate / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D015641:Radiography, Interventional; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000700:Analgesics; D019904:Polymethyl Methacrylate