Long‐term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty

TLDR

The study aimed to evaluate the immediate and long‑term efficacy and safety of percutaneous vertebroplasty with PMMA for refractory pain due to osteoporotic vertebral fractures. A retrospective open study of 40 patients treated between 1990 and 1996 with PMMA vertebroplasty, followed up for a mean of 48 months, assessed pain changes using the Huskisson visual analogue scale. Pain scores fell from a mean of 80 mm to 34 mm at long‑term follow‑up, with no severe complications or vertebral deformity progression, but a modestly increased risk of adjacent vertebral fracture (OR 2.27).

Abstract

To assess the immediate and long-term efficacy and safety of percutaneous vertebroplasty with polymethylmethacrylate (PMMA) for the treatment of refractory pain resulting from osteoporotic vertebral fractures.A retrospective, open study of percutaneous vertebroplasty (PV) was conducted with long-term follow-up. PV with PMMA was carried out between 1990 and 1996 in 40 patients with symptomatic osteoporotic vertebral fracture(s) that had not responded to maximum medical therapy. In 1997, each patient was asked to come back to our institution for a physical and spinal X-ray examination. Efficacy was assessed by changes over time in pain on Huskisson's visual analogue scale (VAS).Thirty-four vertebrae treated by PV in 25 patients were evaluated with long-term follow-up. The mean duration of follow-up was 48 months (range 12-84 months). Pain assessed by the VAS significantly (P<0.05) decreased from a mean of 80 mm+/-16 (S.D.) before PV to 37+/-24 mm after 1 month and 34+/-28 mm at the time of maximal follow-up. There was no severe complication related to this treatment, and no progression of vertebral deformity in any of the injected vertebrae. However, there was a slight but significantly increased risk of vertebral fracture in the vicinity of a cemented vertebra (odds ratio 2.27, 95% confidence interval 1.1-4.56). The odds ratio of a vertebral fracture in the vicinity of an uncemented fractured vertebra was 1.44 (0.82-2.55).PV appears to be a safe and useful procedure for the treatment of focal back pain secondary to osteoporotic vertebral fracture when conservative treatment has failed.