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Randomized Controlled Trial
. 2007 Mar;28(3):555-60.

Percutaneous vertebroplasty compared with optimal pain medication treatment: short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures. The VERTOS study

M H J Voormolen  1 , W P T M Mali, P N M Lohle, H Fransen, L E H Lampmann, Y van der Graaf, J R Juttmann, X Jansssens, H J J Verhaar
Affiliations
Randomized Controlled Trial

Percutaneous vertebroplasty compared with optimal pain medication treatment: short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures. The VERTOS study

M H J Voormolen et al. AJNR Am J Neuroradiol. 2007 Mar.

Abstract

Purpose: To prospectively assess the short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures (VCF) treated with percutaneous vertebroplasty (PV) compared with optimal pain medication (OPM).

Methods: Randomization of patients in 2 groups: treatment by PV or OPM. After 2 weeks, patients from the OPM arm could change therapy to PV. Patients were evaluated 1 day and 2 weeks after treatment. Visual analog score (VAS) for pain and analgesic use were assessed before, and 1 day and 2 weeks after start of treatment. Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) and Roland-Morris Disability (RMD) questionnaire scores were assessed before and 2 weeks after start of treatment. Follow-up scores in patients requesting PV treatment after 2 weeks OPM treatment were compared with scores during their OPM period.

Results: Eighteen patients treated with PV compared with 16 patients treated with OPM had significantly better VAS and used less analgesics 1 day after treatment. Two weeks after treatment, the mean VAS was less but not significantly different in patients treated with OPM, whereas these patients used significantly less analgesics and had better QUALEFFO and RMD scores. Scores in the PV arm were influenced by occurrence of new VCF in 2 patients. After 2 weeks OPM, 14 patients requested PV treatment. All scores, 1 day and 2 weeks after PV, were significantly better compared with scores during conservative treatment.

Conclusion: Pain relief and improvement of mobility, function, and stature after PV is immediate and significantly better in the short term compared with OPM treatment.

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Figures

Fig 1.
Fig 1.
Randomization scheme in 34 patients randomized in either the percutaneous vertebroplasty (PV) treatment arm (n = 18 patients) or the optimal pain medication (OPM) treatment arm (n = 16 patients). After 2 weeks of treatment, 14 patients treated by OPM requested treatment by PV and 2 patients continued the OPM treatment.
See this image and copyright information in PMC

Comment in

  • VERTOS: A Step in the Right Direction.
    Jarvik JG, Hollingworth W. Jarvik JG, et al. AJNR Am J Neuroradiol. 2007 Mar;28(3):561-2. AJNR Am J Neuroradiol. 2007. PMID: 17353336 Free PMC article. No abstract available.

References

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