Journal of Vascular and Interventional Radiology
Clinical StudiesProspective Evaluation of Pain Relief in 100 Patients Undergoing Percutaneous Vertebroplasty: Results and Follow-up
Section snippets
Study Population
A prospective study was undertaken over a 35-month period in which 100 consecutive patients were treated at a single institution. Institutional review board approval was obtained. Twenty-one men and 79 women with a mean age of 73.7 years (37–94 y) were treated. One hundred fifty-six vertebral bodies were treated (68 thoracic, 88 lumbar).
The indication for percutaneous vertebroplasty was painful vertebral body compression fracture(s) refractory to medical therapy. Failure of medical therapy was
RESULTS
We were technically successful in all treated vertebrae. At 12–24 hours, patients were seen and asked to subjectively report their pain as being improved, unchanged, or worse than before the procedure. Ninety-seven percent (97 of 100 patients) reported improvement and three patients reported their condition unchanged. There were two minor adverse events and no major adverse events in our patient population. One patient sustained a sternal fracture before percutaneous vertebroplasty while
DISCUSSION
Osteoporotic compression fractures may result in severe persistent back pain. The pain can often limit mobility and impact the patient's quality of life. Conservative treatment with external bracing, analgesics, and bedrest may be all that is required for pain control in certain patients. However, patients with severe osteoporosis may continue to experience protracted pain despite these conservative measures.
PMMA has been used in spine stabilization for metastatic disease in earlier series (5, 6
CONCLUSION
Percutaneous vertebroplasty is a minimally invasive therapy in the treatment of painful compression fractures that are refractory to conservative treatment. As we have shown in our prospective study of 100 patients, the procedure restores patient mobility and provides immediate and extended pain relief of symptomatic vertebral body compression fractures. A controlled, randomized trial is now needed.
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None of the authors has identified a conflict of interest.