Vertebroplasty in Osteoporotic Vertebral Fractures: Technical Considerations and Complications

Abstract

Background: Osteoporosis is a global problem involving majority of elderly population. Vertebral compression fracture in this population leads to severe pain and decreased quality of life. Percutaneous vertebroplasty alleviates the pain, with a minimal invasive approach. The aim of our study was to analyze the technical considerations and complications of this surgery. Materials and methods: Vertebroplasty was performed in 35 patients with male: female ratio 13:22 in the age group of 52-80 years. We used unipedicular needle insertion and injected 2-3 mL of high-viscosity polymethylmethacrylate in the fractured vertebral body. Visual analog score, Oswestry disability score, and Oswestry disability index were used to analyze functional outcome. Results: Pain relief had a significant p value (<0.0001). Oswestry disability score and index showed a good improvement in the quality of life with a p value < 0.0001. The Beck index did not show a significant change postoperatively. Complications encountered were cement extravasation into venous pathway, cement extravasation into the soft tissue, cement extravasation into the needle tract, and adjacent vertebral fractures. No major complication was encountered. Conclusion: Vertebroplasty provides better pain relief, improved function, and quality of life than conservative management. Use of an appropriate technique will improve the overall success rate of the procedure and minimize the complications. Clinical significance: For patients with osteoporotic fractures who do not respond to conservative measures, vertebroplasty is a simple, effective, and minimally invasive procedure providing adequate pain relief and improving the quality of life.