title: [Therapeutic effect of conservative treatment of refracture in cemented vertebrae after percutaneous vertebroplasty for osteoporotic vertebral compression fractures].
abstract: OBJECTIVE
  To evaluate the therapeutic effects of conservative treatment of refracture in cemented vertebrae after percutaneous vertebroplasty for osteoporotic vertebral compression fractures in elderly patients.
  
  
  METHODS
  Between January, 2012 and August, 2014, a total of 324 elderly patients (381 vertebrae) received percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Of these patients, 12 patients (14 vertebrae) complained of recurrence of back pain and were confirmed to have refracture in the cemented vertebrae by imaging examination. Seven of these 12 patients (9 vertebrae), who were all female with an average refracture time of 8±6.7 weeks (range 2-20 weeks), received conservative treatments with analgesics, osteoporosis medication, bracing and physical therapy, and their visual analogue scale (VAS) scores and Oswestry disability index (ODI) at 7 days and 1, 3 and 12 months after the treatment were measured.
  
  
  RESULTS
  The 7 patients were followed up for 21.3±11.2 months (range 13-29 months) after conservative treatments. Their VAS score and ODI decreased significantly over time after the treatment (P<0.05) and showed significant differences between the measurements at 7 days, 1 and 3 months (P<0.05) but not between 3 and 12 months (P>0.05). The average VAS score and ODI before treatments were 8.3±0.8 and (88.3±3.2)%, 3.1±1.2 and (56.3±7.7)% at 1 month, and 0.8±0.7 and (5.9±2.8)% at 3 months during the follow-up, respectively.No such complications as phlebothrombosis of the leg, decubitus, or hypostatic pneumonia occurred in these cases.
  
  
  CONCLUSIONS
  Though with a relatively low incidence rate, refracture in the cemented vertebrae is one of the important causes of recurrence of back pain following percutaneous vertebroplasty. Conservative treatment is effective in relieving pain and improving the spine function in such cases without obvious complications.
authors.affiliation: Department of Orthopedics, First Affiliated Hospital of Jinan University, Guangzhou 510632, China. E-mail: twjing@jnu.edu.cn.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Min
authors.initials: M
authors.lastname: Chen
authors.forename: Jiang
authors.initials: J
authors.lastname: DU
mesh_terms: D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D001416:Back Pain / Q000628:therapy*; D001843:Bone Cements; D005260:Female; D050815:Fractures, Compression / Q000601:surgery / Q000628:therapy*; D006801:Humans; D010024:Osteoporosis / Q000601:surgery / Q000628:therapy*; D059408:Pain Management; D010147:Pain Measurement; D012008:Recurrence; D016103:Spinal Fractures / Q000601:surgery / Q000628:therapy*; D013131:Spine / Q000473:pathology; D016896:Treatment Outcome; D054854:Vertebroplasty
chemical_list: D000700:Analgesics; D001843:Bone Cements