Prospective clinical follow-up after percutaneous vertebroplasty in patients with painful osteoporotic vertebral compression fractures

Abstract

Purpose: To prospectively assess short-term, midterm, and long-term pain relief in patients with painful osteoporotic vertebral compression fractures (VCFs) treated with percutaneous vertebroplasty (PV).

Materials and methods: Visual analog scale (VAS) scores for pain at the treated vertebral level, analgesic use, and satisfaction with outcome were assessed in 112 patients after PV of 168 VCFs. Serial follow-up was performed at 24 hours and 3, 6, and 12 months and in a small number of patients at 1-3 years. Procedure-related complications were evaluated by physical examination and computed tomography of treated levels.

Results: After PV, VAS scores for pain at the individual vertebral levels treated and use of analgesic agents were significantly reduced compared with before treatment at every follow-up period. Within 24 hours after the procedure, the decreases in all scores were less compared with scores at later follow-up periods, but this was not significant. The preprocedural mean VAS score was 8.8 (range, 5-10). At follow-up, mean VAS scores ranged from 2.5 to 3.3 (range, 0-10). In the short term after PV, patients used significantly less analgesic drugs and 86% of patients were satisfied with the outcome. At midterm and long-term follow-up, patients used even less analgesic drugs and 95%-100% of patients were satisfied with the outcome of PV. Procedure-related complications with clinical consequences occurred in three patients (2.7%): one patient experienced a cardiovascular reaction, one patient had a pedicle chip fracture, and one had a rib fracture.

Conclusion: PV of painful osteoporotic VCFs provides significant pain reduction in nearly all treated patients.