Percutaneous vertebroplasty immediately relieves pain of osteoporotic vertebral compression fractures and prevents prolonged immobilization of patients

Abstract

To assess the immediate efficacy of percutaneous vertebroplasty (PVP) in relief of pain and improving mobility of patients with vertebral compression fractures (VCF) secondary to osteoporosis, 205 cases (175 patients) underwent 250 percutaneous injections of polymethylmethacrylate (PMMA; unilateral, 247 levels; bilateral, 3 levels) into vertebrae under CT and fluoroscopic guidance for 34 months. Patients were prospectively asked to quantify their pain on a visual analog scale (VAS) before and a day after PVP. The interval to mobilization was recorded in those who were immobilized because of pain and/or bed-rest therapy (115 cases). PVP was technically successful in all patients, with three cases of minimal complications. The mean VAS score available for 196 cases was improved from 7.22+/-1.89 (range, 3-10) to 2.07+/-1.19 (range, 0-10) by PVP. Ninety-four of 115 immobilized cases (81.7%) were mobile by 24 h after PVP, and the mean value was 1.9+/-2.8 days. The incidence of recurrent and new fractures was 15.6% in 4-25 months (mean, 15.3 months). PVP is a safe and effective treatment for relieving the pain associated with osteoporotic VCF and strengthening the vertebrae, avoiding refractures. This therapy leads to early mobilization and avoidance of the dangers of conservative therapy of bed-rest.

Differences in endplate deformation of the adjacent and augmented vertebra following cement augmentation

“…The conclusions of this study are based on a cement fill equivalent to 20% of the vertebral volume (approximately 6-8 ml for a typical lumbar vertebra). This value is comparable to that performed clinically (3.9-8.7 ml) [14,19,25] and the minimum value required to reduce the fracture risk of high fracture risk vertebral bodies [46]. Rohlmann et al [44] have proposed that vertebral fracture geometry increases adjacent endplate stresses significantly more than increasing the stiffness of the augmented vertebra through the injection of PMMA.…”

Differences in persistence, safety and efficacy of generic and original branded once weekly bisphosphonates in patients with postmenopausal osteoporosis: 1-year results of a retrospective patient chart review analysis

“…Treatment options for osteoporosis have substantially improved in recent years [1,2,[4][5][6]: appropriate antiresorptive or anabolic medications are available to prevent future fractures.…”

Vertebroplasty: benefits are more than risks in selected and evidence-based informed patients. A retrospective study of 59 cases

“…Since then, indications were extended to spinal column metastatic lesions, myelomas and acute vertebral fractures. During the past decades there has been adequate evidence in support of its safety, immediate pain reduction effectiveness exceeds 90% of cases and biomechanical stability [17][18][19][20][21]. Anyway, patient selection criteria and precise indications about timing of treatment for osteoporotic vertebral fractures have not been established yet.…”