Optimizing Patient Selection in Percutaneous Vertebroplasty

Stallmeyer, M.J.B.; Zoarski, Gregg H.; Obuchowski, Abraham

doi:10.1097/01.rvi.0000064859.87207.fa

Cited by 82 publications

(49 citation statements)

References 68 publications

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“…mesmo ao se identificar que em outubro de 2005, uma porção significativa dos pacientes apresentava dor ao deambular ou nas atividades diárias, 14 deles responderam que ficaram satisfeitos com procedimento. o achado de dor é um sintoma bastante encontrado em pacientes de faixa etária avançada, principalmente devido a alta incidência de discopatia degenerativa e espondiloartrose 20 . os 14 pacientes que optaram por realizar a vP novamente relataram nos questionários que a intensidade e o tipo da dor lombar atual era diferente daquela sentida antes da vP, quando apresentavam Fcv.…”

Section: Discussionunclassified

Vertebroplastia percutânea nas fraturas vertebrais por osteoporose: avaliação a longo prazo

Astacio

Marchiori

Gasparetto

et al. 2007

Arq. Neuro-Psiquiatr.

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Resumo -Objetivo: Avaliar a resposta terapêutica a longo prazo da vertebroplastia percutânea para o tratamento da dor decorrente de fraturas de corpo vertebral por osteoporose. Método: Foram realizadas 26 vertebroplastias percutâneas em 15 pacientes com dor por fraturas osteoporóticas de corpo vertebral, durante o período de julho de 2001 a maio de 2004. Imediatamente antes e após o procedimento, foi aferido o grau de dor de cada paciente com base em uma escala verbal álgica entre zero e dez. esta aferição foi repetida a longo prazo, com um ano de intervalo, sendo ainda investigada a satisfação do paciente, a deambulação e as atividades diárias (escalas de cinco pontos). Resultados: observou-se que a maioria dos pacientes (n=13) apresentava escala verbal de dor entre 8 e 10 antes da vertebroplastia. Houve importante redução álgica no dia seguinte, com 9 pacientes apresentando ausência de dor e três pacientes escala álgica entre 1 e 4 (p<0,001). No acompanhamento a longo prazo, com um ano de intervalo, a melhora dos sintomas se manteve, sem diferença significativa na escala de dor, na deambulação e nas atividades diárias. Quando questionados se fariam novamente este tratamento no caso de nova fratura vertebral, 14 pacientes responderam que sim. Conclusão: A vertebroplastia percutânea pode ocasionar importante melhora da dor em pacientes com fraturas osteoporóticas de corpo vertebral, quando bem selecionados, com boa resposta a longo prazo.PAlAvRAs-cHAve: vertebroplastia percutânea, osteoporose, fratura vertebral. percutaneous vertebroplasty for vertebral osteoporotic fractures: long term analysisABsTRAcT -Objective: To assess the long-term efficacy of percutaneous vertebroplasty for the treatment of pain resulting from osteoporotic vertebral fractures. Method: 26 percutaneous vertebroplasty procedures were performed for osteoporotic vertebral fractures in 15 patients during the period between July 2001 and may 2004. Before and after the procedure, a 10-point scale of pain was obtained. These scale was repeated at long-term follow up in two different moments after the procedure with one year interval. During these moments, the satisfaction, ambulation and ability to perform activities of daily living (five-point scale) were also analyzed. Results: The majority of patients (n=13) presented the 10-point pain scale between 8 and 10 before the percutaneous vertebroplasty. After the procedure, there was important improve of the pain, and nine patients presented zero point-scale and three patients between 1 and 4 (p<0.001). At long-term follow up with one year interval, there was no significant difference between the pain scale, the ambulation and the ability to perform activities of daily living. Fourteen patients reported a future willingness to undergo the procedure for treatment in case of a new compression fracture. Conclusion: Percutaneous vertebroplasty can be a useful procedure for the treatment of pain and disability after secondary osteoporotic vertebral fractures with durable results in selected patients.

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Section: Discussionunclassified

Vertebroplastia percutânea nas fraturas vertebrais por osteoporose: avaliação a longo prazo

Astacio

Marchiori

Gasparetto

et al. 2007

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

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“…Often, multiple osteoporotic VCFs existed in the same patient, including healed and painful VCFs. Healed VCFs do not benefit from VP, while leaving painful vertebral fractures untreated may reduce the effect of VP 7 . Many patients with multiple fractures of uncertain age did not have clear localizing pain upon physical examination; therefore, magnetic resonance imaging is important in order to determine the site of healed and painful osteoporotic VCFs 8,14 .…”

Section: Discussionmentioning

confidence: 99%

“…Bone marrow edema was hypointense on T1-weighted images, and hyperintense on STIR images 4,11 . On T2-weighted images without fat saturation, bone marrow edema was seen as hyperintensity or hypointensity because of the relatively high signal intensity of fatty marrow and the variable reactive fibrosis present at different time courses of the fractures 7 . Intravertebral clefts have frequently been considered as avascular necrosis 6,9 .…”

Section: Methodsmentioning

confidence: 99%

“…Painful osteoporotic VCFs were defined as the presence of non-radiating back pain that increases with weight bearing or can be exacerbated by manual palpation or knocking of the spinous process of the involved vertebra, and having at least one of the following features on serial plain films and/or MR images: progressively decreased vertebral body height, presence of intravertebral clefts, presence of bone marrow edema [1][2][3][4][5][6][7][8][9] . In general, fractures with bone edema showed enhancement of vertebral bodies in the post-contrast T1-weighted MRI 8 .…”

Section: Methodsmentioning

confidence: 99%

“…Painful vertebral compression fractures (VCFs) usually have at least one of the following features on radiographs and/or MR images: progressively decreased vertebral body height, intravertebral clefts, and bone marrow edema [1][2][3][4][5][6][7][8][9] . Healed osteoporotic VCFs without bone marrow edema and intravertebral clefts are usually not indicated for VP because these patients usually experience little or no pain relief after VP [1][2][3]5,7 . Radiographs and magnetic resonance imaging can help determine the site of painful osteoporotic VCFs if pain and tenderness on palpation or knocking of the spinous process was mild or unclear 8 .…”

Section: Introductionmentioning

confidence: 99%

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Are Non-Contrast MR Images Enough for Detection of Fracture Levels Prior to Percutaneous Vertebroplasty in Patients with Osteoporosis?

et al. 2008

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We evaluated the detectability of painful vertebral compression fractures (VCFs) on different MRI protocols in 40 osteoporotic patients with thoraco-lumbar osteoporotic vertebral fractures. Five hundred and ten thoracic and lumbar vertebrae in 40 patients were evaluated. All patients underwent percutaneous vertebroplasty. Vertebral fractures were found in 126 (24.7%) of 510 vertebrae. Healed vertebral fractures were found in 33 (26.2%) of 126 vertebral fractures. Painful osteoporotic VCFs was found in 93 (73.8%) of 126 fractures. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of contrast-enhanced MR images, and the non-contrasted combined protocol (including T1-weighted, T2-weighted and STIR images) for the detection of painful osteoporotic VCFs were all more than 90%. Therefore, the non-contrasted combined protocol can be used for detection of painful osteoporotic VCFs prior to percutaneous vertebroplasty, unless there are conditions where contrast-enhanced MR is needed to rule out other causes of VCFs.

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Percutaneous vertebroplasty and kyphoplasty for the stand‐alone augmentation of osteoporosis‐induced vertebral compression fractures: Present status and future directions

Lewis

2006

J Biomed Mater Res

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Enormous research efforts are being expended on two minimally invasive procedures: percutaneous vertebroplasty (VP) and kyphoplasty (KP). The present report, which is a detailed critical review of VP and KP that emphasizes their biomechanics aspects, is divided into six parts. In the first two parts, succinct descriptions are given of osteoporosis-induced vertebral body (VB) compression fractures as the underlying pathology to be treated with VP and KP, the theory of VP and KP, and the techniques used in performing these procedures. Concerns about VP and KP, such as the high radiation exposure burden that may be imposed on both patient and medical personnel and extravasation of the injectable bone cement, are discussed in the third part. Detailed discussions of fourteen issues/questions, such as the extent to which VP or KP affects various biomechanical measures of the augmented VB and those adjacent to it and the appropriate volume of the cement to use, are presented in the fourth part. Ideas for future research, such as development of a new generation of injectable bone cements and identification of an appropriate animal model, are covered in the fifth part. The final section contains a summary of the most salient points/observations made in the report.

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Optimizing Patient Selection in Percutaneous Vertebroplasty

Cited by 82 publications

References 68 publications

Vertebroplastia percutânea nas fraturas vertebrais por osteoporose: avaliação a longo prazo

Vertebroplastia percutânea nas fraturas vertebrais por osteoporose: avaliação a longo prazo

Are Non-Contrast MR Images Enough for Detection of Fracture Levels Prior to Percutaneous Vertebroplasty in Patients with Osteoporosis?

Percutaneous vertebroplasty and kyphoplasty for the stand‐alone augmentation of osteoporosis‐induced vertebral compression fractures: Present status and future directions

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