Clinical outcome and safety of multilevel vertebroplasty: clinical experience and results.
OBJECTIVE
To compare safety and efficacy of percutaneous vertebroplasty (PVP) when treating up to three vertebrae or more than three vertebrae per session.


METHODS
We prospectively compared two groups of patients with symptomatic vertebral fractures who had no significant response to conservative therapy. Pathologic substrate included osteoporosis (n = 77), metastasis (n = 24), multiple myeloma (n = 13), hemangioma (n = 15), and lymphoma (n = 1). Group A patients (n = 94) underwent PVP of up to three treated vertebrae (n = 188). Group B patients (n = 36) underwent PVP with more than three treated vertebrae per session (n = 220). Decreased pain and improved mobility were recorded the day after surgery and at 12 and 24 months after surgery per clinical evaluation and the use of numeric visual scales (NVS): the Greek Brief Pain Inventory, a linear analogue self-assessment questionnaire, and a World Health Organization questionnaire.


RESULTS
Group A presented with a mean pain score of 7.9 ± 1.1 NVS units before PVP, which decreased to 2.1 ± 1.6, 2.0 ± 1.5 and 2.0 ± 1.5 NVS units the day after surgery and at 12 and 24 months after surgery, respectively. Group B presented with a mean pain score of 8.1 ± 1.3 NVS units before PVP, which decreased to 2.2 ± 1.3, 2.0 ± 1.5, and 2.1 ± 1.6 NVS units the day after surgery and at 12 and 24 months after surgery, respectively. Overall pain decrease and mobility improvement throughout the follow-up period presented no statistical significance neither between the two groups nor between different underlying aetiology. Reported cement leakages presented no statistical significance between the two groups (p = 0.365).


CONCLUSIONS
PVP is an efficient and safe technique for symptomatic vertebral fractures independently of the vertebrae number treated per session.
Second Department of Radiology, Athens University School of Medicine, Attikon University Hospital, 12462, Athens, Greece. lmailli@hotmail.com
Leto
L
Mailli
Dimitrios K
DK
Filippiadis
Elias N
EN
Brountzos
Efthymia
E
Alexopoulou
Nikolaos
N
Kelekis
Alexios
A
Kelekis
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001843:Bone Cements / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000601:surgery; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D055361:Multilevel Analysis; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000503:physiopathology; D061214:Patient Safety; D011446:Prospective Studies; D011859:Radiography; D012647:Self-Assessment; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D018709:Statistics, Nonparametric; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000009:adverse effects / Q000379:methods*
D001843:Bone Cements