Percutaneous vertebroplasty for painful compression fractures in a small cohort of patients with a decreased expectation-related placebo effect due to dementia.
OBJECTIVE
Although abundant literature has reported success with vertebroplasty for the treatment of painful compression fractures, none has accounted for a potential expectation-related placebo effect. We report the results of vertebroplasty for painful vertebral body compression fractures in a small cohort of patients with dementia with the assumption that this patient subgroup is subjected to a decreased placebo effect.


METHODS
All patients with objective evidence of dementia (N = 10) who had undergone vertebroplasty at our institution were identified from a comprehensive prospectively constructed vertebroplasty data base. The patients' pain at rest and activity, mobility, and pain-medication use were analyzed at 2 hours postprocedure, 1 week, 1 month, 6 months, and 1 year.


RESULTS
Pain with activity decreased or resolved in 80%-100% of patients at each time point, whereas pain at rest decreased or resolved in 78%-100% of all patients at each time point. Improved mobility was reported in 80%-100% of patients at all time points. Pain medication was decreased or stopped in 67% of patients at 1 week and in 100% of patients at 6 months and 1 year.


CONCLUSIONS
Treatment of painful compression fractures in patients with dementia demonstrates a high rate of success regarding pain relief and mobility. This study offers additional evidence that vertebroplasty has true benefit.
Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
V T
VT
Lehman
L A
LA
Gray
D F
DF
Kallmes
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D050815:Fractures, Compression; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology*; D059408:Pain Management; D015990:Placebo Effect; D012189:Retrospective Studies; D016103:Spinal Fractures; D013315:Stress, Psychological / Q000453:epidemiology*; D016896:Treatment Outcome; D054854:Vertebroplasty