Percutaneous vertebroplasty: the follow-up

Abstract

Purpose. This article reports on our experience treating vertebral fractures with percutaneous vertebroplasty. A clinical and imaging follow-up designed to identify the early (especially pulmonary embolism of bone cement) and late complications of the technique is proposed. Material and methods. On the basis of the current guidelines, 101 patients were selected: 64 osteoporotic and 37 neoplastic. A total of 173 vertebrae were treated. Procedures were performed with both computed tomography and fluoroscopic guidance. Residual pain was evaluated with a visual analogue scale score immediately after vertebroplasty and 1, 15, 30, 90, 180 and 270 days later. Spine and chest radiographs were obtained 24 h after vertebroplasty; spine radiography was repeated 30 days later. Results. Therapeutic success was obtained in 88% of osteoporotic patients and in 84% of neoplastic patients. Pulmonary cement emboli were identified in four patients, all of whom were asymptomatic. Conclusions. Percutaneous vertebroplasty is a safe and

Treatment of vertebral pathological fractures by percutaneous vertebroplasty

“…[21][22][23][24] Amar et al published a study with a total of 97 patients with osteoporotic fractures and osteolytic neoplasias who had undergone PV. 11,14 The average age was 76 years. The use of analgesic medications was reduced in 63% of the patients, increased in 7%, and unchanged in 30%.…”

“…11, 14 Trout et al 35 reported that the relative risk of developing a new fracture at a level adjacent to the vertebroplasty is 4.62 times higher than at a non-adjacent level.…”

“…8,9,11 Percutaneous vertebroplasty, although its pain improvement mechanism has not been defined, whether due to the heat released by the bone cement that has a cauterizing effect on the nerve ends of the vertebral bodies, or as a result of the stabilization of the vertebral body preventing microfractures, has surprising results both for pain relief and the stabilization of the vertebral body. [12][13][14] Biomechanical tests have shown that PV generally restores or increases the strength and rigidity of the vertebral body compared to pre-fracture values and probably provides an internal splint that prevents local movement of the fracture. 15,16 However, the pain relief action mechanism is still unknown.…”

Coaxial biopsy during percutaneous vertebroplasty in patients with presumed osteoporotic vertebral compression fractures: retrospective review of biopsy results

“…Spesso l'eziologia neoplastica è indistinguibile da quella porotica sulla base dei soli esami strumentali [3]. Molti pazienti che vanno incontro ad uno o più crolli vertebrali non trovano giovamento o sollievo dalla terapia farmacologica o contentiva (busti, corsetti ortopedici) mentre negli ultimi anni la vertebroplastica percutanea (VP) si è dimostrata efficace sia per il controllo del dolore sia per un rapido recupero funzionale del soggetto [4][5][6][7].…”

“…Imaging alone is often unable to distinguish a neoplastic from osteoporotic aetiology [3]. Many patients who develop one or more vertebral compression fractures gain no benefit or pain relief from medication or containment devices (braces, orthopaedic corsets), whereas percutaneous vertebroplasty (PVP) has recently been shown to be effective for both pain control and rapid functional recovery [4][5][6][7].…”