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A prospective study of percutaneous vertebroplasty for chronic painful osteoporotic vertebral compression fracture.

Tan HY, Wang LM, Zhao L, Liu YL, Song RP - Pain Res Manag (2014)

Bottom Line: The PVP procedures were technically successful and well tolerated in all patients.Compared with baseline scores, improvement in visual analogue scale, Oswestry Disability Index, QUALEFFO and Roland Morris Disability Questionnaire scores was significantly greater after PVP at one week (P<0.001), one month (P<0.001), three months (P<0.001), six months (P<0.001) and one year (P<0.001), and the number of patients using drugs for pain treatment was significantly reduced.Pain relief after PVP was immediate, was sustained for one year and may be an important factor for reducing persistent pain.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Percutaneous vertebroplasty (PVP) for patients with chronic painful osteoporotic compression fractures has not been extensively studied.

Objective: To prospectively evaluate the efficacy of PVP for patients with chronic painful osteoporotic vertebral compression fractures (VCFs).

Methods: Sixty-two consecutive patients with chronic painful osteoporotic VCFs for ≥3 months underwent PVP. All procedures were performed under local anesthesia. The outcomes were pain relief at one week, one month, three months, six months and one year, as measured by visual analogue scale, Oswestry Disability Index, Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) and Roland Morris Disability Questionnaire scores.

Results: The PVP procedures were technically successful and well tolerated in all patients. Sixty-two patients underwent PVP on 92 vertebrae in 73 procedures three to five days after referral, and no 30-day mortality was observed. Compared with baseline scores, improvement in visual analogue scale, Oswestry Disability Index, QUALEFFO and Roland Morris Disability Questionnaire scores was significantly greater after PVP at one week (P<0.001), one month (P<0.001), three months (P<0.001), six months (P<0.001) and one year (P<0.001), and the number of patients using drugs for pain treatment was significantly reduced. Five new fractures were reported in five of 62 patients treated with PVP during follow-up.

Conclusion: PVP is effective in patients with chronic painful osteoporotic VCFs. Pain relief after PVP was immediate, was sustained for one year and may be an important factor for reducing persistent pain.

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Related in: MedlinePlus

A 74-year-old male patient with persistent back pain and a visual analogue scale score of 7 for >10 months. Coronary (A) and sagittal (B) computed tomography reconstruction demonstrates a border of osteosclerosis at the fracture site (arrow). Anteroposterior (C) and lateral (D) plain films show bone cement injected into the L1 and L2 vertebral bodies with slight vein leakage (arrow) at the L2 level. Magnetic resonance imaging reveals low signal (arrowhead) on T1WI images (E) and high signal (arrowhead) on T2WI (F) at the L1 level before percutaneous vertebroplasty. Note also a hemangioma (arrow) at the L2 level. Magnetic resonance imaging displays low signal (arrowhead) on T1WI (G) and slightly high signal (arrowhead) on T2WI (H) images at the L1 level one year after percutaneous vertebroplasty with stability of the vertebral body without obvious focal kyphosis
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f1-prm-20-e8: A 74-year-old male patient with persistent back pain and a visual analogue scale score of 7 for >10 months. Coronary (A) and sagittal (B) computed tomography reconstruction demonstrates a border of osteosclerosis at the fracture site (arrow). Anteroposterior (C) and lateral (D) plain films show bone cement injected into the L1 and L2 vertebral bodies with slight vein leakage (arrow) at the L2 level. Magnetic resonance imaging reveals low signal (arrowhead) on T1WI images (E) and high signal (arrowhead) on T2WI (F) at the L1 level before percutaneous vertebroplasty. Note also a hemangioma (arrow) at the L2 level. Magnetic resonance imaging displays low signal (arrowhead) on T1WI (G) and slightly high signal (arrowhead) on T2WI (H) images at the L1 level one year after percutaneous vertebroplasty with stability of the vertebral body without obvious focal kyphosis

Mentions: The inclusion criteria for the present prospective study were as follows: patients ≥50 years of age with definite history of VCF with back pain for at least three months (Figure 1); level of fracture between T5 and L5; visual analogue scale (VAS) score of ≥5; focal tenderness at fracture level as assessed by an internist on physical examination; decreased bone density (T scores ≤−1); and clinical and imaging follow-up taken ≥12 months after the initial treatment. Exclusion criteria were: severe cardiopulmonary comorbidity (n=0); untreatable coagulopathy (n=0); systemic or local spine infection (n=0); suspected underlying malignant disease (n=0); radicular syndrome (n=2); spinal cord compression syndrome (n=3); and contraindication for magnetic resonance imaging (MRI) (n=5).


A prospective study of percutaneous vertebroplasty for chronic painful osteoporotic vertebral compression fracture.

Tan HY, Wang LM, Zhao L, Liu YL, Song RP - Pain Res Manag (2014)

A 74-year-old male patient with persistent back pain and a visual analogue scale score of 7 for >10 months. Coronary (A) and sagittal (B) computed tomography reconstruction demonstrates a border of osteosclerosis at the fracture site (arrow). Anteroposterior (C) and lateral (D) plain films show bone cement injected into the L1 and L2 vertebral bodies with slight vein leakage (arrow) at the L2 level. Magnetic resonance imaging reveals low signal (arrowhead) on T1WI images (E) and high signal (arrowhead) on T2WI (F) at the L1 level before percutaneous vertebroplasty. Note also a hemangioma (arrow) at the L2 level. Magnetic resonance imaging displays low signal (arrowhead) on T1WI (G) and slightly high signal (arrowhead) on T2WI (H) images at the L1 level one year after percutaneous vertebroplasty with stability of the vertebral body without obvious focal kyphosis
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325899&req=5

f1-prm-20-e8: A 74-year-old male patient with persistent back pain and a visual analogue scale score of 7 for >10 months. Coronary (A) and sagittal (B) computed tomography reconstruction demonstrates a border of osteosclerosis at the fracture site (arrow). Anteroposterior (C) and lateral (D) plain films show bone cement injected into the L1 and L2 vertebral bodies with slight vein leakage (arrow) at the L2 level. Magnetic resonance imaging reveals low signal (arrowhead) on T1WI images (E) and high signal (arrowhead) on T2WI (F) at the L1 level before percutaneous vertebroplasty. Note also a hemangioma (arrow) at the L2 level. Magnetic resonance imaging displays low signal (arrowhead) on T1WI (G) and slightly high signal (arrowhead) on T2WI (H) images at the L1 level one year after percutaneous vertebroplasty with stability of the vertebral body without obvious focal kyphosis
Mentions: The inclusion criteria for the present prospective study were as follows: patients ≥50 years of age with definite history of VCF with back pain for at least three months (Figure 1); level of fracture between T5 and L5; visual analogue scale (VAS) score of ≥5; focal tenderness at fracture level as assessed by an internist on physical examination; decreased bone density (T scores ≤−1); and clinical and imaging follow-up taken ≥12 months after the initial treatment. Exclusion criteria were: severe cardiopulmonary comorbidity (n=0); untreatable coagulopathy (n=0); systemic or local spine infection (n=0); suspected underlying malignant disease (n=0); radicular syndrome (n=2); spinal cord compression syndrome (n=3); and contraindication for magnetic resonance imaging (MRI) (n=5).

Bottom Line: The PVP procedures were technically successful and well tolerated in all patients.Compared with baseline scores, improvement in visual analogue scale, Oswestry Disability Index, QUALEFFO and Roland Morris Disability Questionnaire scores was significantly greater after PVP at one week (P<0.001), one month (P<0.001), three months (P<0.001), six months (P<0.001) and one year (P<0.001), and the number of patients using drugs for pain treatment was significantly reduced.Pain relief after PVP was immediate, was sustained for one year and may be an important factor for reducing persistent pain.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Percutaneous vertebroplasty (PVP) for patients with chronic painful osteoporotic compression fractures has not been extensively studied.

Objective: To prospectively evaluate the efficacy of PVP for patients with chronic painful osteoporotic vertebral compression fractures (VCFs).

Methods: Sixty-two consecutive patients with chronic painful osteoporotic VCFs for ≥3 months underwent PVP. All procedures were performed under local anesthesia. The outcomes were pain relief at one week, one month, three months, six months and one year, as measured by visual analogue scale, Oswestry Disability Index, Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) and Roland Morris Disability Questionnaire scores.

Results: The PVP procedures were technically successful and well tolerated in all patients. Sixty-two patients underwent PVP on 92 vertebrae in 73 procedures three to five days after referral, and no 30-day mortality was observed. Compared with baseline scores, improvement in visual analogue scale, Oswestry Disability Index, QUALEFFO and Roland Morris Disability Questionnaire scores was significantly greater after PVP at one week (P<0.001), one month (P<0.001), three months (P<0.001), six months (P<0.001) and one year (P<0.001), and the number of patients using drugs for pain treatment was significantly reduced. Five new fractures were reported in five of 62 patients treated with PVP during follow-up.

Conclusion: PVP is effective in patients with chronic painful osteoporotic VCFs. Pain relief after PVP was immediate, was sustained for one year and may be an important factor for reducing persistent pain.

Show MeSH
Related in: MedlinePlus