Pain reduction in osteoporotic patients with vertebral pain without measurable compression.
BACKGROUND
Non-compression osteoporotic vertebral pain (NCOVP) can also cause pain and severe immobilization, such as typical vertebral compression fracture (VCF). The aim of this study was to evaluate whether patients with NCOVP refractory to medical treatment and severely affecting normal daily activities could be offered therapeutic benefit with percutaneous vertebroplasty.


METHODS
We conducted a retrospective review of the records of consecutive percutaneous vertebroplasty procedures performed at our institutions during a 28-month period to define a population of patients who suffered from severe NCOVP. Nine such patients were identified based on physical examination, computed tomography, magnetic resonance (MR) imaging, and bone scans. Initial clinical outcomes were assessed by comparing quantitative measurements of pain (10-point scale) and mobility (5-point scale) 1 day before the operation with those 1 day post-operation. A second follow-up took place between 2 weeks and 1 month after the operation, with a third follow-up between 6 and 10 months post-operative. Biopsy was taken in each case.


RESULTS
Each patient demonstrated point tenderness over radiographically normal-shaped vertebra. Every patient showed a low signal on T1W images, and seven cases showed a high signal on T2W images inside the vertebra, indicating bone marrow edema. All patients experienced a reduction in pain and an increase in mobility after percutaneous vertebroplasty, with a mean pain reduction of 7.0 points and an average improved mobility of 2.8 points. Biopsy results indicated necrotic and/or degenerative changes in eight cases.


CONCLUSIONS
The clinical outcomes of our patients suggest that NCOVP, mainly verified by abnormal MR signals and biopsy results, can be successfully treated by percutaneous vertebroplasty.
Yang
Xinjian
X
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Tiantan Xili, Beijing, China. Yang-xj@163.net
Mi
Shijun
S
Mahadevia
Ankit A
AA
Lin
Xin
X
Shi
Wanchao
W
Liu
Aihua
A
Li
Li
L
Wu
Zhongxue
Z
Murphy
Kieran
K
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000150:complications*; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D012189:Retrospective Studies; D013131:Spine; D054854:Vertebroplasty