Percutaneous vertebroplasty in osteoporotic patients: an institutional experience of 1,634 patients with long-term follow-up.
OBJECTIVE
To assess long-term clinical outcome of percutaneous vertebroplasty (PV).


METHODS
PV was performed in 1,634 patients (1,387 women; median age 73 years ± 9.3) with painful osteoporotic vertebral compression fractures (VCFs). All patients had back pain that persisted for ≥ 2 months with a concordant magnetic resonance imaging study. After PV, medical therapy for osteoporosis was continued, and patients were prospectively evaluated (follow-up 11.8-44.9 months, mean 25.0 months). Visual analog scale (VAS), Oswestry Disability Index (ODI), analgesic drug use, and use of external brace support were recorded at baseline and during follow-up. New occurrences of symptomatic vertebral fractures were recorded.


RESULTS
The mean VAS score of 7.94 significantly improved to 1.12 at the primary endpoint (P < .001). Differences in patterns of analgesic usage compared with baseline values were highly statistically significant (marginal homogeneity test, P < .001). Median ODI values of 82% before treatment significantly decreased to 6% (P < .001). Before intervention, 1,279 patients wore a brace; 1,167 (91.2%) patients did not wear a brace after PV (χ(2) = 31.005, P < .0001). A new painful fracture with a significant higher proportion of contiguous vertebrae (63.6%) occurred in 214 (13.1%) patients (z = 7.59, P = .025).


CONCLUSIONS
PV can provide durable pain relief and improvement in ambulation in patients with VCFs.
Institute for Cancer Research and Treatment , Candiolo, Turin, Italy. giovanni.anselmetti@ircc.it
Giovanni Carlo
GC
Anselmetti
Antonio
A
Manca
Joshua
J
Hirsch
Filippo
F
Montemurro
Giancarlo
G
Isaia
Giangiacomo
G
Osella
Gabriele
G
Chiara
Gabriella
G
Iussich
Felicino
F
Debernardi
Daniele
D
Regge
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology* / Q000628:therapy*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D016103:Spinal Fractures / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000706:statistics & numerical data*