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J Vasc Interv Radiol. 2011 Jul;22(7):1017-23. doi: 10.1016/j.jvir.2011.02.036. Epub 2011 May 14.

Percutaneous vertebroplasty in very severe osteoporotic vertebral compression fractures: feasible and beneficial.

Author information

1
Department of Orthopedic Surgery, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands.

Abstract

PURPOSE:

To assess clinical outcome and technical feasibility of percutaneous vertebroplasty (PVP) in 34 patients with 37 osteoporotic vertebral compression fractures (OVCFs) with vertebral body collapse to less than one-third of the original height, termed very severe osteoporotic vertebral compression fractures (vsOVCFs).

MATERIALS AND METHODS:

A prospective follow-up study was conducted using a 0-10 pain intensity numerical rating scale and the Short Form-36 General Health Survey (SF-36) quality-of-life questionnaire, completed before PVP and 7 days (pain only), 1 month, 3 months, and 12 months after PVP. Cement leakage was analyzed on postoperative computed tomography (CT) scanning. The presence of new fractures was assessed at 6 weeks and 52 weeks and when suspected clinically.

RESULTS:

Decrease in average and worst back pain was 2.5 points and 3.0 points after 7 days, and 2.5 points and 2.9 points after 12 months. The physical and mental SF-36 summary scores were significantly increased. Incidence of cement leakage in vsOVCFs was 91.9%, which was substantially higher compared with non-vsOVCFs (n = 40) treated in the same patients (64.1%; odds ratio [OR] 6.4, 95% confidence interval [CI] 1.7-24.5, P = .004). Mean leakage volume per treated vertebra was more than twice as high (0.80 mL vs 0.32 mL; P < .001). Seventeen new OVCFs in 11 patients (32.4%) were identified. Only one (2.9%) minor complication occurred, confirming the feasibility of PVP in vsOVCFs.

CONCLUSIONS:

Patients with painful vsOVCFs can be treated with, and benefit from, PVP. Although technically more demanding and with a higher procedural risk (ie, more frequent necessity of placement of a second needle, higher leakage incidence, and greater leakage volumes), PVP is technically feasible and should not be withheld from these patients.

PMID:
21571548
DOI:
10.1016/j.jvir.2011.02.036
[Indexed for MEDLINE]

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