title: Early Vertebroplasty versus Delayed Vertebroplasty for Acute Osteoporotic Compression Fracture : Are the Results of the Two Surgical Strategies the Same?
abstract: OBJECTIVE
  In Korea, early vertebroplasty (EVP) or delayed vertebroplasty (DVP, which is performed at least 2 weeks after diagnosis) were performed for the treatment of acute osteoporotic compression fracture (OCF) of the spine. The present study compared the outcomes of two surgical strategies for the treatment of single-level acute OCF in the thoracolumbar junction (T12-L2).
  
  
  METHODS
  From 2004 to 2010, 23 patients were allocated to the EVP group (EVPG) and 27 patients to the DVP group (DVPG). Overall mean age was 68.3±7.9 and minimum follow-up period was 1.0 year. Retrospective study of clinical and radiological results was conducted.
  
  
  RESULTS
  No significant differences in baseline characteristics were observed between the two groups. As expected, mean duration from onset to vertebroplasty and mean duration of hospital stay were significantly longer in the DVPG (17.1±2.1 and 17.5±4.2) than in the EVPG (3.8±3.3 and 10.8±5.1, p=0.001). Final clinical outcome including visual analogue scale (VAS), Oswestry Disability Index, and Odom's criteria did not differ between the two groups. However, immediate improvement of the VAS after vertebroplasty was greater in the EVPG (5.1±1.3) than in the DVPG (4.0±1.0, p=0.002). The proportion of cement leakage was lower in the EVPG (30.4%) than in the DVPG (59.3%, p=0.039). In addition, semiquantitative grade of cement interdigitation was significantly more favorable in the EVPG than in the DVPG (p=0.003). Final vertebral body collapse and segmental kyphosis did not differ significantly between the two groups.
  
  
  CONCLUSIONS
  Our findings suggest that EVP achieves a better immediate surgical effect with more favorable cost-effectiveness.
authors.affiliation: Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Seong
authors.initials: S
authors.lastname: Son
authors.affiliation: Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Sang-Gu
authors.initials: SG
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Woo-Kyung
authors.initials: WK
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Chan-Woo
authors.initials: CW
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Chan-Jong
authors.initials: CJ
authors.lastname: Yoo
keywords: Compression fracture; Osteoporosis; Spine; Vertebroplasty