Percutaneous vertebroplasty in octogenarians: results and follow-up.
OBJECTIVE
To determine pain relief, performance status, morbidity, and mortality associated with percutaneous vertebroplasty for spinal pain in patients aged 80 years and older.


METHODS
Prospective, descriptive, third-party independent interview, clinical audit.


METHODS
University Hospital, Geneva, Switzerland.


METHODS
Patients aged 80 years and older who underwent vertebroplasty between August 1997 and August 2004 because of vertebral fractures from osteoporotic or malignant etiologies.


METHODS
Primary outcome measures were verbal rating scale (VRS) (0--no pain, 5--intolerable) and Eastern Cooperative Oncology Group (ECOG) performance status scale (0--normal activity, 4--unable to get out of bed) before and after procedure. Patients were interviewed 8 to 35 months post treatment (mean 25), independently assessed for pain relief, analgesic consumption, and overall satisfaction by using the American Society of Anesthesiologists (ASA) Outcome Measures questionnaire.


RESULTS
Mean VRS scores significantly decreased from 4.86 +/- 0.64 to 2.39 +/- 1.14 (P < 0.05), and mean ECOG performance scores improved from 1.87 +/- 0.97 to 1.29 +/- 1.06 (P < 0.05) after treatment. When patients were analyzed by etiology (group 1--cancer; group 2--osteoporosis), both groups significantly reduced their VRS (P < 0.05); however, only group I significantly improved their performance (P < 0.05; P = 0.334, respectively). Nine patients answered the ASA questionnaire (18 deceased, 1 demented, 1 lost to follow-up) and reported an improvement in their ability to perform daily tasks. No early or late complications were observed; none of the deaths were procedure-related.


CONCLUSIONS
Percutaneous vertebroplasty is a safe, minimally invasive, well-tolerated analgesic procedure among octogenarians suffering from spinal pain, permitting increased activities of daily living. Pain reduction is significant regardless of the etiology; performance scores are significantly improved in cancer pain.
Cahana
Alex
A
Interventional Pain Program, Department of Anesthesiology, University Hospitals of Geneva, Geneva, Switzerland. alex.cahana@hcuge.ch
Seium
Yodit
Y
Diby
Marc
M
Martin
Jean-Baptiste
JB
Ruefenacht
Daniel
D
Dietrich
Pierre Yves
PY