title: Percutaneous vertebroplasty compared with optimal pain medication treatment: short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures. The VERTOS study.
abstract: OBJECTIVE
  To prospectively assess the short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures (VCF) treated with percutaneous vertebroplasty (PV) compared with optimal pain medication (OPM).
  
  
  METHODS
  Randomization of patients in 2 groups: treatment by PV or OPM. After 2 weeks, patients from the OPM arm could change therapy to PV. Patients were evaluated 1 day and 2 weeks after treatment. Visual analog score (VAS) for pain and analgesic use were assessed before, and 1 day and 2 weeks after start of treatment. Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) and Roland-Morris Disability (RMD) questionnaire scores were assessed before and 2 weeks after start of treatment. Follow-up scores in patients requesting PV treatment after 2 weeks OPM treatment were compared with scores during their OPM period.
  
  
  RESULTS
  Eighteen patients treated with PV compared with 16 patients treated with OPM had significantly better VAS and used less analgesics 1 day after treatment. Two weeks after treatment, the mean VAS was less but not significantly different in patients treated with OPM, whereas these patients used significantly less analgesics and had better QUALEFFO and RMD scores. Scores in the PV arm were influenced by occurrence of new VCF in 2 patients. After 2 weeks OPM, 14 patients requested PV treatment. All scores, 1 day and 2 weeks after PV, were significantly better compared with scores during conservative treatment.
  
  
  CONCLUSIONS
  Pain relief and improvement of mobility, function, and stature after PV is immediate and significantly better in the short term compared with OPM treatment.
authors.affiliation: Department of Radiology, St Elisabeth Ziekenhuis, Tilburg, The Netherlands. mhjvoorm@12move.nl
authors.forename: M H J
authors.initials: MH
authors.lastname: Voormolen
authors.forename: W P T M
authors.initials: WP
authors.lastname: Mali
authors.forename: P N M
authors.initials: PN
authors.lastname: Lohle
authors.forename: H
authors.initials: H
authors.lastname: Fransen
authors.forename: L E H
authors.initials: LE
authors.lastname: Lampmann
authors.forename: Y
authors.initials: Y
authors.lastname: van der Graaf
authors.forename: J R
authors.initials: JR
authors.lastname: Juttmann
authors.forename: X
authors.initials: X
authors.lastname: Jansssens
authors.forename: H J J
authors.initials: HJ
authors.lastname: Verhaar
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D001843:Bone Cements / Q000627:therapeutic use*; D002908:Chronic Disease; D018592:Cross-Over Studies; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D010024:Osteoporosis / Q000150:complications; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D016103:Spinal Fractures / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D001843:Bone Cements