Vertebroplasty in the treatment of osteoporosis vertebral fractures: report on 52 cases.
BACKGROUND
Percutaneous vertebroplasty (PV) is largely employed in vertebral body compression fractures (VCF).


OBJECTIVE
To evaluate the efficacy of PV on pain relief and functional status, and its complications rate.


METHODS
A prospective observational study was conducted by the Division of Internal Medicine of St. Croce and Carle Hospital.


METHODS
Diagnosis of osteoporosis, intense back pain, unresponsive to conservative treatment, associated with radiological evidence of recent VCF. Pain control and functional improvement were respectively assessed using Visual Analogue Scale (VAS) and Activity of Daily Living scale (ADL) on admission, 24 h after PV and at follow-up. PV complications were detected by an immediate computed tomography (CT) scan on the vertebra treated as well as the vertebrae above and below the treated level(s) and by CT chest scan to exclude pulmonary emboli. A magnetic resonance imaging (MRI) follow-up at 6 or 12 months was performed.


RESULTS
Fifty-two (46 with primary osteoporosis) patients were enrolled (mean age 73.18 yr, range 44-92). Median follow-up was 20.4 months (range 6-24). Treated vertebrae were 124. VAS, mean value was 9.05 (range 6-10) before treatment, 5.95 (range 2-8) at 24 h after PV and 4.94 (range 2-9) at follow-up (p<0.001). Before PV, 18 patients (34.6%) were functionally impaired vs 8 patients (15.3%) at follow-up (p<0.003). Control MRI evidenced 9 (17.3%) new VCF adjacent and 13 (25%) non-adjacent to treated vertebras. There was one case of discitis. Seven cases (13%) of cement leakage in para-vertebral space were observed.


CONCLUSIONS
PV is safe and effective in immediate pain reduction and functional improvement and at a median term follow-up.
Fenoglio
L
L
Department of Internal Medicine, St. Croce Hospital, Cuneo, Italy. medicina.interna@ospedale.cuneo.it
Cena
P
P
Migliore
E
E
Bracco
C
C
Ferrigno
D
D
Silvestri
A
A
Lingua
G
G
Gollè
G
G
Brignone
C
C
Serraino
C
C
Gallarato
G
G
Pomero
F
F
Grosso
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000517:prevention & control; D016009:Chi-Square Distribution; D050815:Fractures, Compression / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010024:Osteoporosis / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D016103:Spinal Fractures / Q000601:surgery*; D054854:Vertebroplasty / Q000379:methods*