Treatment of multiple osteoporotic vertebral compression fractures by percutaneous cement augmentation

Abstract

Purpose: Vertebral compression fractures cause significant pain and some patients are debilitated by the pain due to the fracture. Conventional surgery carries a high risk and has a poor outcome. Vertebroplasty is a minimally invasive surgical procedure, which in vertebral fractures restores stability and diminishes pain. The aim of the study was to analyse the effectiveness and safety of vertebroplasty in multiple vertebral compression fractures with a 24-month follow-up.

Methods: Vertebroplasty was performed in 160 patients with multiple osteoporotic compression fractures under local anaesthesia, using a unilateral transpedicular approach. The level of pain was assessed according to a 10-cm visual analogue scale. The patients were observed for 24 months after surgery.

Results: Vertebroplasty significantly diminished the level of pain in 90% of patients, and half of them were free of pain within 12 hours after surgery. Only 4% of the patients did not benefit from this type of treatment. During the 24-month follow-up these results changed only slightly, and after two years almost 80% still benefited, while the number of unsatisfactory results changed from 6 to 9%. No serious clinical complications were noted; in three patients new fractures appeared during the two year observation period.

Conclusions: Vertebroplasty should be seriously taken into account as a primary method of treatment in patients with multiple osteoporotic vertebral compression fractures.