Response of Nonmidline Pain to Percutaneous Vertebroplasty

Abstract

Most patients presenting for percutaneous vertebroplasty have nonmidline pain. Vertebroplasty reduced or eliminated nonmidline pain in 76-92% of the patients in whom it was reported. Procedures involving lumbar vertebrae tended to be successful less often than others, but even in these patients the procedure was successful in approximately 75%.

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 ).…”

Pain Relief following Vertebroplasty in Patients With and Without Localizing Tenderness on Palpation

“…Gibson et al 13 reported an overall 83% improvement of nonmidline pain in 240 patients postvertebroplasty. However, these authors did not report whether these same patients also had focal tenderness to palpation.…”

“…Gaughen et al, 12 in a small series of patients, noted good pain relief in patients without localizing pain. Gibson et al, 13 in a larger series of patients, noted good outcomes in most of patients who had pain distant from the treated level or levels. However, this latter publication did not indicate whether focal tenderness was present in these patients in addition to the nonlocalizing pain pattern.…”

The Effect of Vertebroplasty on Costal Pain Related to Osteoporotic Thoracic Compression Fractures in Elderly Patients

“…To our knowledge, there are few reports regarding the incidence of costal pain following an osteoporotic vertebral compression fracture 10 , 17) . Also, some patients who exhibit osteoporotic compression fractures in the thoracic spine would complain of back pain and pain in non-midline areas such as the rib, chest, hip, groin, and buttock, simultaneously 6 , 10 , 18 , 19) .…”

“…Several studies showed the comparable outcome of patients without VP to patients with VP, and many articles have presented the effectiveness of a VP on the clinical outcome 1 , 3 , 7 , 12) . However, some patients who exhibit osteoporotic compression fractures in the thoracic spine complained of back pain and pain of nonmidline areas such as the rib, chest, hip, groin, and buttocks, simultaneously 6 , 10 , 18 , 19) . Among the non-midline pains, the ribs were the most common site and, the overall response of VP for the non-midline pain was 83% 10) .…”