title: Percutaneous vertebroplasty in a series of myasthenic patients with steroid-induced symptomatic vertebral fractures.
abstract: Vertebral compression fractures (VFs) are observed in 30-50 % of patients affected by steroid-induced osteoporosis, with consequentially severe back pain and functional limitation. An alternative treatment to medical therapy for pain caused by recent VFs is percutaneous vertebroplasty (PVP). Patients were treated by PVP after careful selection, based on the presence of persistent pain not resolved by standard medical therapy, correlation between pain and level of the VF, and neuroradiological features. We performed PVP in 4 patients with generalized MG associated with recent steroid-induced symptomatic VFs. Relief from pain was very rapid, usually within 24 h, and retained at a 3-month evaluation. No severe complication or MG worsening were observed in the post-operative period. Although clinical indication for PVP is still controversial, in our experience PVP is a useful and safe tool to be considered in the management of recent steroid-induced symptomatic VFs in selected MG patients.
authors.affiliation: Neuroimmunology and Muscle Pathology Unit, Foundation IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan, Italy. lorenzo.maggi@istituto-besta.it
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Maggi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Faragò
authors.forename: Renato
authors.initials: R
authors.lastname: Mantegazza
authors.forename: Elisa
authors.initials: E
authors.lastname: Ciceri
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000188:drug therapy*; D010147:Pain Measurement; D013116:Spinal Cord / Q000473:pathology*; D016103:Spinal Fractures / Q000139:chemically induced* / Q000601:surgery*; D013256:Steroids / Q000009:adverse effects*; D054854:Vertebroplasty / Q000379:methods*
chemical_list: D013256:Steroids
references.citation: AJNR Am J Neuroradiol. 2006 Oct;27(9):1938-43
references.pmid: 17032871
references.citation: AJNR Am J Neuroradiol. 2007 Sep;28(8):1439-43
references.pmid: 17846187
references.citation: N Engl J Med. 2009 Nov 19;361(21):2097-8; author reply 2099-100
references.pmid: 19923582
references.citation: J Vasc Interv Radiol. 2006 Jan;17(1):71-6
references.pmid: 16415135
references.citation: Curr Osteoporos Rep. 2009 Mar;7(1):23-6
references.pmid: 19239826
references.citation: Radiol Res Pract. 2011;2011:175079
references.pmid: 22091375
references.citation: J Vasc Interv Radiol. 2003 Sep;14(9 Pt 2):S311-5
references.pmid: 14514838
references.citation: N Engl J Med. 2009 Aug 6;361(6):557-68
references.pmid: 19657121
references.citation: N Engl J Med. 2009 Aug 6;361(6):569-79
references.pmid: 19657122
references.citation: Clin Orthop Relat Res. 2012 Oct;470(10):2785-99
references.pmid: 22729693