Percutaneous vertebroplasty treatment of steroid-induced osteoporotic compression fractures

Abstract

This report describes the case of a woman in whom multiple compression fractures of the lower thoracic and lumbar spine occurred in association with long-term corticosteroid therapy for systemic lupus erythematosus. Pain markedly limited the patient's mobility and daily activities, and conservative therapy with bracing and narcotic analgesics gave little improvement. Affected vertebrae were treated with polymethylmethacrylate, introduced percutaneously under fluoroscopic guidance. The resulting reinforcement of the fractured vertebral bodies eliminated the pain and the need for narcotic analgesics. The utilization of percutaneous verterbroplasty as a therapeutic alternative for the treatment of pain resulting from osteoporotic compression fractures is described.

Outcome of CT-guided vertebroplasty in outpatients with severe vertebral compression fractures

“…In individual cases it may take a few days or weeks before the patient can clearly state if the presenting pain has subsided. Significant pain relief has been demonstrated in more than 90% of patients with osteoporotic fractures [7,13,20,21].…”

“…Although we could not find a relationship between reported pain and the volume of cement injected, this cannot be excluded as an explanation in individual cases. On the whole, the results are comparable to those found in the literature [7,13,20,21]. Furthermore, the functional disability due to pain was reduced steadily over the period of observation and short term improvement of overall function was stable over the long term.…”

“…Neurological complications are not usually seen [19,24]. The median volume of PMMA injected per vertebral body in our group was 4.5 ml (range 1.5-6.5 ml), somewhat less than that used in other series reported which ranged from 5.5 to 7.1 ml [13,21].…”

“…It was first described in 1987 for the treatment of vertebral angioma [4] and has since then become increasingly popular in the treatment of osteoporotic vertebral compression fractures. PVP has been reported to effectively reduce pain related to these fractures, when performed on carefully selected patients [5][6][7][8][9]. Reports on complications of PVP are rare and mostly describe the extravasation of cement into nearby structures.…”

Minimally Invasive Vertebral Augmentation Techniques in Osteoporotic Fractures

“…Neuroradiologists in the USA started to use VP in 1993, the first study was published in 1997 [14]. Since the early clinical use a number of articles documented the effectiveness of VP in respect to immediate pain relief and reinforcement of the affected vertebral body after treatment [12][13][14][15][16][17][18][19][20][21][22][23][24][25]. A review of this literature shows that all reports reveal favorable results of pain relief and remobilization following VP.…”