Lack of Preoperative Spinous Process Tenderness Does Not Affect Clinical Success of Percutaneous Vertebroplasty

Balloon kyphoplasty for the treatment of pathological vertebral compressive fractures

“…Tenderness to point pressure over the spinous processes of the fractured vertebrae is a sensitive test but the reproducibility of the test has not been validated. Another study [11] reported that the pain on palpation over the fractured vertebra is not a necessary requirement in selecting patients who will benefit from percutaneous vertebroplasty. Other factors, such as MR evidence of edema, should be taken into account in the decision to treat a patient.…”

Clinical Utility of Vertebroplasty: Elevating the Evidence

“…Currently, there is no strong evidence that particular features of either the fracture itself or the treatment confer a better outcome. Specifi cally, outcomes appear unaltered by the presence of a cleft ( 57 ), the duration of pain ( 48 ), volume of cement infused ( 39,58 ), and subjective or objective pattern of pain ( 47,59 ).…”

Response of Nonmidline Pain to Percutaneous Vertebroplasty

“…A 2002 article by Gaughen et al [24] describes 10 of 100 consecutive patients with no point tenderness over their fracture site. These patients had "tenderness distant from the frac-ture (n = 5), tenderness lateral to the fracture (n = 4), or no focal tenderness at all (n = 1)."…”