Treatment of painful Modic type I changes by vertebral augmentation with bioactive resorbable bone cement.
BACKGROUND
Low back pain is one of the most common causes of seeking medical attention in industrialized western countries. End plate degenerative changes in the acute phase, formally referred to as Modic type I, represent a specific cause. The aim of this study is to evaluate the effectiveness of vertebral augmentation with calcium sulfate and hydroxyapatite resorbable cement in patients with low back pain resistant to conservative treatment whose origin can be recognized in Modic type I changes.


METHODS
From February 2009 to October 2013, 1,124 patients with low back pain without radicular symptoms underwent physical and imaging evaluation. Stringent inclusion criteria elected 218 to vertebral augmentation with resorbable cement. Follow-up period was 1 year.


RESULTS
One hundred seventy-two (79 %) patients improved quickly during the first 4 weeks after treatment. Forty-two (19 %) patients showed a more gradual improvement over the first 6 months, and at 1 year, their pain level did not differ from that of the previous group. In both groups, pain did not resolved completely, but patients showed significant improvement in their daily life activities. Two (1 %) patients did not show any improvement. Two (1 %) patients died for other reasons. There were no complications related to the procedures.


CONCLUSIONS
Vertebroplasty with bioactive resorbable bone cement seems to be an effective therapeutic option for patients with low back pain resistant to conservative treatment whose origin could be recognized in Modic type I end plate degenerative changes.
Department of Diagnostic and Interventional Radiology, "Fondazione PTV"-Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
Salvatore
S
Masala
Giovanni Carlo
GC
Anselmetti
Stefano
S
Marcia
Giovanni
G
Nano
Amedeo
A
Taglieri
Eros
E
Calabria
Marcello
M
Chiocchi
Giovanni
G
Simonetti
D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use; D001843:Bone Cements / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000627:therapeutic use*; D002133:Calcium Sulfate / Q000627:therapeutic use*; D015331:Cohort Studies; D004338:Drug Combinations; D017886:Durapatite / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000473:pathology / Q000628:therapy*; D017116:Low Back Pain / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D054854:Vertebroplasty
D001672:Biocompatible Materials; D001843:Bone Cements; D018786:Bone Substitutes; D004338:Drug Combinations; C582328:cerament; D017886:Durapatite; D002133:Calcium Sulfate