Unilateral percutaneous vertebroplasty for symptomatic osteoporotic vertebral compression fractures -evaluation of radiological and clinical outcomes
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20185328Keywords:
Verterbroplasty, Vertebral fractures, Osteoporosis, PVPAbstract
Background: Vertebral fractures are the most common type of osteoporotic fractures. These are developing into a significant health problem worldwide as about 30% of the patients above 50 years suffer from a fracture secondary to osteoporosis. Osteoporotic vertebral fractures may be treated with rest and analgesics. Some fractures may also require surgery. Percutaneous procedure like vertebroplasty and kyphoplasty done under local anaesthesia can reduce the pain and restore height of vertebral body without need for an open surgery. The aim of the study was to assess the clinical and radiological outcomes following unilateral percutaneous vertebroplasty under local anaesthesia.
Methods: 21 patients who underwent unilateral vertebroplasty for symptomatic osteoporotic compression fracture between 2012 and 2015 were included in the study. Unilateral vertebroplasty using an 11-gauge trocar through transpedicular technique was performed under c-arm guidance. Patient was mobilized as soon as tolerated. Oswestry disability index and visual analogue scale were assessed pre-operatively, in the immediate post-op and at 1-year follow up.
Results: There were 15 females and 6 males. The mean age was 70.04±6.07 years. The pre-op ODI score was 76.8±7.6. The pre-op VAS score was 7.66±0.71. The average time period from fracture to vertebroplasty is 4.19±3.19 days. The immediate post-operative VAS score was 5.76±0.8 and the ODI score was 62.85±7.17. The VAS at final follow up was 1.23±1.19. ODI at final follow up was 9.04±3.19. There was a showed a significant improvement when preoperative, immediate post-operative ODI and VAS scores and final follow up (p<0.001).
Conclusions: In our study unilateral percutaneous vertebroplasty has provided pain relief, early mobilization of the patient with less complication without the requirement of general anaesthesia.
References
Ballane G, Cauley JA, Luckey MM, Fuleihan GE, Worldwide prevalence and incidence of osteoporotic vertebral fractures. Osteoporosis Int. 2017;6:10-2.
Cockerill W1, Lunt M, Silman AJ, Cooper C, Lips P, Bhalla AK, et al. Health-related quality of life and radiographic vertebral fracture. Osteoporosis Int. 2004;15:113–9.
Prather H, Van Dillen L, Metzler JP, Riew KD, Gilula LA. Prospective measurement of function and pain in patients with non-neoplastic compression fractures treated with vertebroplasty. J Bone Joint Surg Am. 2006;88(2):334-41.
Fairbank JC, Couper J, Davies JB, O’brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy. 1980;66(8):271-3.
Huskisson EC. Visual analogue scales. In: Melzack R. (Ed.) Pain measurement and assessment. Raven, New York: 1983: 33–37.
Manson NA, Phillips FM. Minimally invasive techniques for the treatment of osteoporotic vertebral fractures. J Bone Joint Surg Am. 2006;88(8):1862-72.
Wood KB, Li W, Lebl DS, Ploumis A. Management of thoracolumbar spine fractures. The Spine Journal. 2014; 14(1):145-64.
Diel P, Merky D, Roder C, Popp A, Perler M, Heini PF. Safety and efficacy of vertebroplasty: early results of a prospective one-year case series of osteoporosis patients in an academic high-volume center. Indian J Orthopaedics. 2009;43(3):228.
Prather H, Van Dillen L, Metzler JP, Riew KD, Gilula LA. Prospective measurement of function and pain in patients with non-neoplastic compression fractures treated with vertebroplasty. J Bone Joint Surg Am. 2006;88(2):334-41.
Mpotsaris A, Abdolvahabi R, Hoffleith B, Nickel J, Harati A, Loehr C, et al. Percutaneous vertebroplasty in vertebral compression fractures of benign or malignant origin. Deutsches Ärzteblatt International. 2011;108(19):331-8.
Muijs SP, Nieuwenhuijse MJ, Van Erkel AR, Dijkstra PD. Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures. Bone Joint J. 2009;91(3):379-84.
Klazen CA, Lohle PN, de Vries J, Jansen FH, Tielbeek AV, Blonk MC, et al. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomized trial. The Lancet. 2010;376(9746):1085-92.
Martin DJ, Rad AE, Kallmes DF. Prevalence of extra vertebral cement leakage after vertebroplasty: procedural documentation versus CT detection. Acta Radiologica. 2012;53(5):569-72.
