Abstract
Object
To determine the safety and efficacy of computed tomography (CT)/fluoroscopy-guided percutaneous vertebroplasty (PVP) for the treatment of painful severe osteoporotic compression fractures.
Materials and methods
In 26 patients with osteoporotic severe and non-severe compression fractures experiencing pain, 55 PVP were performed. Pain relief and improvement of function were estimated using the Visual Analog Scale (VAS), Pain Disability Index (PDI) and Hannover functional ability questionnaire (FFbH) at follow-up examinations at a median of 3 (1–31) days and 6.5 (1–18) months after PVP.
Results
Pain relief (VAS and PDI) was significant at first and second follow-up. The improvement of function (FFbH) was statistically significant at the second follow-up. Severity of the compression fractures did not influence these results. There were no clinical complications and no patient required follow-up surgery.
Conclusion
PVP is a safe and effective treatment of pain even in severe osteoporotic vertebral body compression fractures. The advantages of CT-guidance in combination with fluoroscopy technique are a minimally invasive precise procedure with high visualization and with low risk, performed cost effective on out patient basis in local anesthesia, leading to an early recovery of individual independence.
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References
Ismail AA, Cooper C, Felsenberg D et al (1999) Number and type of vertebral deformities: epidemiological characteristics and relation to back pain and height loss. European Vertebral Osteoporosis Study Group. Osteoporos Int 9: 206–213
Matthis C, Weber U, O’Neill TW, Raspe H (1998) Health impact associated with vertebral deformities: results from the European Vertebral Osteoporosis Study (EVOS). Osteoporos Int 8: 364–372
Heaney RP (1992) The natural history of vertebral osteoporosis: is low bone mass an epiphenomenon. Bone 13(Suppl 2): 23–26
Galibert P, Deramond H, Rosat P, Le Gars D (1987) [Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty]. Neurochirurgie 33: 166–168
Gangi A, Kastler BA, Dietemann JL (1994) Percutaneous vertebropslasty guided by a combination of CT and fluoroscopy. AJNR Am J Neuroradiol 15: 83–86
Cortet B, Cotten A, Boutry N et al (1999) Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study. J Rheumatol 26: 2222–2228
Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion JE (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol 18: 1897–1904
Mathis JM, Petri M, Naff N (1998) Percutaneous vertebroplasty treatment of steroid-induced osteoporotic compression fractures. Arthritis Rheum 41: 171–175
Zoarski GH, Snow P, Olan WJ et al (2002) Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. J Vasc Interv Radiol 13: 139–148
Hardouin P, Grados F, Cotten A, Cortet B (2001) Should percutaneous vertebroplasty be used to treat osteoporotic fractures? An update. Joint Bone Spine 68: 216–221
Harrington KD (2001) Major neurological complications following percutaneous vertebroplasty with polymethylmethacrylate: a case report. J Bone Joint Surg Am 83-A: 1070–1073
Klockner C, Weber U (2001) Surgical possibilities in the treatment of diseases and injuries of the spine in patients with manifest osteoporosis. Orthopäde 30: 473–478
Peh WCG, Gilula LA, Peck DD (2002) Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Radiology 223: 121–126
Cyteval C, Sarrabere MP, Roux JO et al (1999) Acute osteoporotic vertebral collapse: open study on percutaneous injection of acrylic surgical cement in 20 patients. AJR Am J Roentgenol 173: 1685–1690
Barr MS, Barr JD (1998) Percutaneous vertebroplasty: State of the art—invited commentary. Radiographics 18: 320–322
Kallmes DF, Jensen ME (2003) Percutaneous vertebroplasty. Radiology 229: 27–36
Eastell R, Cedel SL, Wahner HW et al (1991) Classification of vertebral fractures. J Bone Miner Res 6: 207–215
Cotten A, Boutry N, Cortet B et al (1998) Percutaneous vertebroplasty: state of the art. RadioGraphics 18: 311–320
Deramond H, Depriester C, Galibert P, Le Gars D (1998) Percutaneous vertebroplasty with polymethylmethacrylate: technique, indications, and results. Radiol Clin North Am 36: 533–546
Barr JD, Barr MS, Lemley TJ, McCann RM (2000) Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 25: 923–928
Mathis JM, Petri M, Naff N (1998) Percutaneous vertebroplasty treatment of steroid-induced osteoporotic compression fractures. Arthritis Rheum 41: 171–175
O’Brien JP, Sims JT, Evans AJ (2000) Vertebroplasty in Patients with Severe Vertebral Compression Fractures: A Technical Report. Am J Neuroradiol 21: 1555–1558
Cotten A, Dewatre F, Cortet B et al (1996) Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up. Radiology 200: 525–530
Deramond H, Depriester C, Toussaint P, Galibert P (1997) Percutaneous vertebroplasty. Semin Musculoskelet Radiol 1: 285–296
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Braun, M., Gevargez, A., Lange, S. et al. Outcome of CT-guided vertebroplasty in outpatients with severe vertebral compression fractures. Int J CARS 2, 363–370 (2008). https://doi.org/10.1007/s11548-008-0151-7
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DOI: https://doi.org/10.1007/s11548-008-0151-7