Comparison of Vertebroplasty Versus Vertebral Perforation for the Treatment of Acute Vertebral Compression Fractures

Abstract

Aim: The efficacy of vertebroplasty on acute vertebral compression fractures (VCFs) has not yet been established. This study, focusing on patients with acute VCFs, aims to compare therapeutic effects between vertebroplasty and vertebral perforation without cement injection.

Material and methods: Fifty-five patients with single painful VCFs were assigned to undergo vertebroplasty (Vertebroplasty group; 28 patients) or vertebral perforation (Perforation group; 27 patients). Analgesic effects before and after surgery were compared between 2 groups. Furthermore, the frequency of new VCFs during the follow-up period was compared.

Results: In both groups, the visual analog scale (VAS) scores markedly decreased immediately after surgery and remained low until 90 days after surgery (p < 0.05). However, in the Perforation group, the analgesic effect from postoperative day 7 to 90 was significantly lower in patients with vertebral mobility before surgery than those without mobility (p < 0.05). New fractures after surgery occurred in 12 (42.9%) of the 28 patients in the Vertebroplasty group and 8 (29.6%) of the 27 patients in the Perforation group (p =0.054).

Conclusion: In acute VCFs, vertebroplasty exerts a marked analgesic effect, which does not differ much from that of vertebral perforation without cement injection. Considering the risk of new postoperative fractures, the application of bone cement infusion should be carefully considered in patients with acute VCF.