title: Long-term therapeutic effects of vertebroplasty for painful vertebral compression fracture: a retrospective comparative study.
abstract: As a treatment for painful vertebral compression fractures (VCFs), vertebral perforation does not require bone cement infusion. Here, we retrospectively assessed the long-term therapeutic effects of vertebroplasty in a comparison with those of vertebral perforation. The subjects were 64 patients who underwent percutaneous vertebroplasty (PVP group) and 67 patients who underwent vertebral perforation (Perforation group) between 2006 and 2011 at Takeda general hospital. We compared the analgesic effects of the treatments and the incidences of new VCFs between the groups at 15 months postsurgery. The pain scores on a visual analog scale 15 months postsurgery were 2.3 ± 2.0 in the PVP group and 2.1 ± 1.4 in the Perforation group, a nonsignificant difference (p = .90). The presence of vertebral mobility did not influence the analgesic effect in either group. New VCFs developed at a significantly higher rate in the PVP group (n = 27, 52%) compared to the Perforation group (n = 11, 24%; p = .0017). This difference was even greater within 3 months of the surgery, in 19 PVP patients (38%) and two Perforation patients (3.0%; p < .0001). However, the incidence after 3 months was eight PVP patients and nine Perforation patients, a nonsignificant difference (p = .50). The Kaplan-Meier analysis suggested that the new fractures after surgery in both treatment groups may occur at the same frequency at around 31 months postoperatively. Vertebroplasty is more effective than vertebral perforation in relieving pain early in the course of treatment, but over the long term, no significant difference in pain was seen between the two treatments. The complication of new fractures seen with cement vertebroplasty is only seen after the procedure.
authors.affiliation: a Department of Neurosurgery , Takeda General Hospital , Fushimi Kyoto , Japan.
authors.forename: Kunio
authors.initials: K
authors.lastname: Yokoyama
authors.affiliation: a Department of Neurosurgery , Takeda General Hospital , Fushimi Kyoto , Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kawanishi
authors.affiliation: a Department of Neurosurgery , Takeda General Hospital , Fushimi Kyoto , Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamada
authors.affiliation: a Department of Neurosurgery , Takeda General Hospital , Fushimi Kyoto , Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: a Department of Neurosurgery , Takeda General Hospital , Fushimi Kyoto , Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ito
authors.affiliation: b Department of Neurosurgery and Department of Surgical Pathology , Osaka Medical College , Takatsuki , Osaka, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Kuroiwa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000009:adverse effects; D005260:Female; D050815:Fractures, Compression / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010147:Pain Measurement; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*
chemical_list: D001843:Bone Cements
keywords: Vertebral compression fracture; percutaneous vertebroplasty; percutaneus vertebral perforation