Percutaneous Vertebroplasty Versus Conservative Treatment and Rehabilitation in Women with Vertebral Fractures due to Osteoporosis: A Prospective Comparative Study.
BACKGROUND
Percutaneous vertebroplasty is commonly used in the management of osteoporosis-related vertebral fractures, although there is controversy on its superiority over conservative treatment. Here we compare pain and function in women with vertebral osteoporotic fractures who underwent percutaneous vertebroplasty versus conservative treatment with a protocolized rehabilitation program.


METHODS
A longitudinal and comparative prospective study was conducted. Women ≥ 60 years of age with a diagnosis of osteoporosis who had at least one vertebral thoracic or lumbar compression fracture were included and divided into two groups, conservative treatment or vertebroplasty. The Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were used to assess pain and function, respectively, as the outcome measures.


RESULTS
We included 31 patients, 13 (42%) treated with percutaneous vertebroplasty and 18 (58%) with conservative treatment. Baseline clinical characteristics, bone densitometry and fracture data were similar in both groups. At baseline, VAS was 73.1 ± 28.36 in the vertebroplasty group and 68.6 ± 36.1 mm in the conservative treatment group (p = 0.632); at three months it was 33.11 ± 10.1 vs. 42 ± 22.21 mm (p = 0.111); and at 12 months, 32.3 ± 11.21 vs. 36.1 ± 12.36 mm (p = 0.821). The ODI at baseline was 83% in the vertebroplasty group vs. 85% for conservative management (p = 0.34); at three months, 36 vs. 39% (p = 0.36); and at 12 months, 29.38 vs. 28.33% (p = 0.66).


CONCLUSIONS
Treatment with percutaneous vertebroplasty had no advantages over conservative treatment for pain and function in this group of women ≥ 60 years of age with osteoporosis.
Department of Osteoarticular Rehabilitation, Instituto Nacional de Rehabilitación, México D.F., Mexico.
Salvador Israel
SI
Macías-Hernández
Subdivision of Medicine, Instituto Nacional de Rehabilitación, México D.F., Mexico.
Daniel David
DD
Chávez-Arias
Department of Investigation, Instituto Nacional de Rehabilitación, México D.F., Mexico.
Antonio
A
Miranda-Duarte
Department of Orthopedic Rehabilitation, Instituto Nacional de Rehabilitación, México D.F., Mexico.
Roberto
R
Coronado-Zarco
Osteoporosis Clinic, Instituto Nacional de Rehabilitación, México D.F., Mexico.
María Pilar
MP
Diez-García
D000368:Aged; D000369:Aged, 80 and over; D000072700:Conservative Treatment / Q000379:methods*; D005260:Female; D050815:Fractures, Compression / Q000209:etiology / Q000601:surgery / Q000628:therapy; D006801:Humans; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications; D058866:Osteoporotic Fractures / Q000601:surgery / Q000628:therapy*; D010147:Pain Measurement; D011446:Prospective Studies; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D013904:Thoracic Vertebrae; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*