Outcomes of patients receiving long-term corticosteroid therapy who undergo percutaneous vertebroplasty.
OBJECTIVE
The purpose of this study was to determine the efficacy and rate of complications in patients undergoing percutaneous vertebroplasty (PVP) for vertebral compression fractures as a result of secondary osteoporosis caused by long-term corticosteroid use compared with patients with primary osteoporosis treated with PVP.


METHODS
A retrospective review of all patients undergoing PVP was conducted to identify patients who also received long-term corticosteroid therapy. Outcomes including pain, periprocedural complications, and frequency of new fractures in patients receiving corticosteroids were compared with control patients undergoing PVP for primary osteoporosis.


RESULTS
Sixty-eight patients receiving long-term corticosteroid therapy underwent 79 PVP procedures. Patients treated with corticosteroids undergoing PVP were significantly younger and more likely to be male compared with control subjects. Patients receiving long-term corticosteroid treatment experienced significant pain relief immediately postprocedure and at 1 week, 1 month, 6 months, 1 year and 2 years postprocedure (P < .0001 at all time points). Patients receiving corticosteroids experienced similar decreases in pain from baseline compared with control subjects at all follow-up time points (P > .05). The complication rate for patients receiving corticosteroids was 4.4% compared with 3.4% for control subjects (P = .60). Patients on long-term corticosteroid treatment did not have an increased risk of new fractures after PVP compared with control subjects (P = .68).


CONCLUSIONS
Percutaneous vertebroplasty performed for vertebral compression fractures as a result of long-term corticosteroid therapy is as safe and effective in relieving pain as PVP performed in patients with vertebral compression fractures as a result of primary osteoporosis.
Koch
C A
CA
Mayo Clinic College of Medicine, Rochester, MI 55905, USA.
Layton
K F
KF
Kallmes
D F
DF
D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D050815:Fractures, Compression / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D010024:Osteoporosis / Q000150:complications; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D001843:Bone Cements