Vertebroplasty, first 1000 levels of a single center: evaluation of the outcomes and complications.
OBJECTIVE
Percutaneous polymethylmethacrylate (PMMA) vertebroplasty has become a common procedure for treatment of pain and disability associated with vertebral compression fractures. We reviewed the experience with our first 1000 consecutively treated vertebral compression fractures in an attempt to demonstrate both the short- and long-term safety and efficacy of percutaneous vertebroplasty.


METHODS
The first 1000 compression fractures treated by vertebroplasty at our institution were identified from a comprehensive prospectively acquired vertebroplasty data base. All patients treated with vertebroplasty were included, regardless of the underlying pathologic cause. Chart reviews of the procedure notes, imaging studies, clinical visits, and follow-up telephone interviews were performed for each patient. Evaluation at each follow-up time point included pain response (subjective and visual analog pain score), change in mobility, change in pain medication usage, and modified Roland-Morris Disability Questionnaire. Statistical analysis was performed on the pain response and change in the Roland-Morris score at each follow-up time point. Significant procedure-related complications that occurred from the time of the procedure were also specifically extracted from the patients' charts.


RESULTS
There was a dramatic improvement in all the evaluated parameters following percutaneous vertebroplasty. The improvement in pain, mobility, medication usage, and Roland-Morris score was noticed immediately after the procedure and persisted through the 2-year follow-up. There was a low rate of complications from the procedure, the most common being rib fractures.


CONCLUSIONS
According to our results, practitioners can quote a high success rate and low complication rate for vertebroplasty when making treatment recommendations for painful spinal compression fractures.
Layton
K F
KF
Department of Radiology, Mayo Clinic, Rochester, MN, USA. klayton@americanrad.com
Thielen
K R
KR
Koch
C A
CA
Luetmer
P H
PH
Lane
J I
JI
Wald
J T
JT
Kallmes
D F
DF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D050815:Fractures, Compression / Q000628:therapy*; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate / Q000008:administration & dosage* / Q000009:adverse effects; D015641:Radiography, Interventional; D016103:Spinal Fractures / Q000628:therapy*; D013904:Thoracic Vertebrae; D016896:Treatment Outcome
D001843:Bone Cements; D019904:Polymethyl Methacrylate