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Published in: European Radiology 1/2009

01-01-2009 | Musculoskeletal

Percutaneous vertebroplasty in 1,253 levels: results and long-term effectiveness in a single centre

Authors: Salvatore Masala, Roberta Mastrangeli, Maria Chiara Petrella, Francesco Massari, Antonio Ursone, Giovanni Simonetti

Published in: European Radiology | Issue 1/2009

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Abstract

Several authors claim that vertebroplasty (PVT) is a successful technique, but long-term effectiveness is still debated. Our goal was to evaluate the effectiveness of PVT in patients with symptomatic vertebral fractures that had not responded to conservative treatment. In our centre, 624 patients with 1,253 compression fractures were treated by PVT. Imaging studies, clinical visits and short- and long-term follow-up were assessed by visual analogue scale (VAS) testing of pain. Statistical analysis was performed to evaluate pain response after PVT (paired two-tailed t-test) and to assess any differences in pain due to different lesions (ANOVA test). We found a statistically significant improvement in the patients’ quality of life, particularly in pain (P < 0.001). The average VAS value pre-PVT was 8.0 ± 2.5, which significantly dropped to 1.5 ± 0.4 by 12 months. There were no significant differences in pain response between the groups of patients with different underlying disease. There was a low complication rate in our study. PVT should be considered the treatment of choice in vertebral fractures with refractory pain. With strict evaluation of the clinical indications and subspecialised operators, long-term effectiveness is probable.
Literature
1.
go back to reference Galibert P, Deramond H, Rosat et al (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 33:166–168PubMed Galibert P, Deramond H, Rosat et al (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 33:166–168PubMed
2.
go back to reference Ettinger B, Black DM, Nevitt MC et al (1992) Contribution of vertebral deformities to chronic back pain and disability. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 7:449–456PubMed Ettinger B, Black DM, Nevitt MC et al (1992) Contribution of vertebral deformities to chronic back pain and disability. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 7:449–456PubMed
3.
go back to reference Silvermann SL (1992) The clinical consequences of vertebral compression fracture. Bone 13:27–31CrossRef Silvermann SL (1992) The clinical consequences of vertebral compression fracture. Bone 13:27–31CrossRef
4.
go back to reference Turner JA, Fulton-Kehoe D, Franklin G et al (2003) Comparision of the Roland-Morris disability questionnaire and generic health status measures: a population based study of workers’ compensation back injury claimants. Spine 28:1061–1067PubMedCrossRef Turner JA, Fulton-Kehoe D, Franklin G et al (2003) Comparision of the Roland-Morris disability questionnaire and generic health status measures: a population based study of workers’ compensation back injury claimants. Spine 28:1061–1067PubMedCrossRef
5.
go back to reference Jensen ME, Evans AJ, Mathis JM et al (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR 18:1897–1904PubMed Jensen ME, Evans AJ, Mathis JM et al (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR 18:1897–1904PubMed
6.
go back to reference Voormolen MH, Mali WP, Lohle PN et al (2007) 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. AJNR 28:555–560PubMed Voormolen MH, Mali WP, Lohle PN et al (2007) 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. AJNR 28:555–560PubMed
7.
go back to reference Evans AJ, Jensen ME, Kip KE et al (2003) Vertebral compression fractures: pain reduction and improvement in functional mobility after percutaneous polymethylmethacrylate vertebroplasty retrospective report of 245 cases. Radiology 226:366–372PubMedCrossRef Evans AJ, Jensen ME, Kip KE et al (2003) Vertebral compression fractures: pain reduction and improvement in functional mobility after percutaneous polymethylmethacrylate vertebroplasty retrospective report of 245 cases. Radiology 226:366–372PubMedCrossRef
8.
go back to reference Diamond TH, Champion B, Clarck WA (2003) Management of acute osteoporotic vertebral fractures: a nonrandomized trial comparing percutaneous vertebroplasty with conservative therapy. Am J Med 114:257–265PubMedCrossRef Diamond TH, Champion B, Clarck WA (2003) Management of acute osteoporotic vertebral fractures: a nonrandomized trial comparing percutaneous vertebroplasty with conservative therapy. Am J Med 114:257–265PubMedCrossRef
9.
go back to reference Anselmetti GC, Corrao G, Monica PD et al (2007) Pain relief following percutaneous vertebroplasty: results of a series of 283 consecutive patients treated in a single institution. Cardiovasc Intervent Radiol 30:441–447PubMedCrossRef Anselmetti GC, Corrao G, Monica PD et al (2007) Pain relief following percutaneous vertebroplasty: results of a series of 283 consecutive patients treated in a single institution. Cardiovasc Intervent Radiol 30:441–447PubMedCrossRef
10.
go back to reference Mathis JM, Barr JD, Belkoff SM et al (2001) Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. AJNR 22:373–381PubMed Mathis JM, Barr JD, Belkoff SM et al (2001) Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. AJNR 22:373–381PubMed
11.
go back to reference Masala S, Cesaroni A, Sergiacomi G et al (2004) Percutaneous kyphoplasty: new treatment for painful vertebral body fractures. In Vivo 18:149–153PubMed Masala S, Cesaroni A, Sergiacomi G et al (2004) Percutaneous kyphoplasty: new treatment for painful vertebral body fractures. In Vivo 18:149–153PubMed
12.
go back to reference Shen MS, Kim YH (2006) Vertebroplasty and Kiphoplasty. Treatment techniques for managing osteoporotic vertebral compression fractures. Bull NYU Hosp Jt Dis 64:106–113PubMed Shen MS, Kim YH (2006) Vertebroplasty and Kiphoplasty. Treatment techniques for managing osteoporotic vertebral compression fractures. Bull NYU Hosp Jt Dis 64:106–113PubMed
13.
go back to reference Mcgraw JK, Gardella I, Barr JD et al (2003) Society of international radiology quality improvement guidelines for percutaneous vertebroplasty. J Vasc Intervent Radiol 14:311–315CrossRef Mcgraw JK, Gardella I, Barr JD et al (2003) Society of international radiology quality improvement guidelines for percutaneous vertebroplasty. J Vasc Intervent Radiol 14:311–315CrossRef
14.
go back to reference Kobayashi K, Shimoyana K, Nakamura K et al (2005) Percutaneous vertebroplasty immediately relieves pain of osteoporotic vertebral compression fractures and prevents prolonged immobilization of patients. Eur Radiol 15:360–367PubMedCrossRef Kobayashi K, Shimoyana K, Nakamura K et al (2005) Percutaneous vertebroplasty immediately relieves pain of osteoporotic vertebral compression fractures and prevents prolonged immobilization of patients. Eur Radiol 15:360–367PubMedCrossRef
15.
go back to reference Alvarez L, Perez-Higueras A, Quinones D et al (2003) Vertebroplasty in the treatment of vertebral tumours: postprocedural outcome and quality of life. Eur Spine J 12:356–360PubMedCrossRef Alvarez L, Perez-Higueras A, Quinones D et al (2003) Vertebroplasty in the treatment of vertebral tumours: postprocedural outcome and quality of life. Eur Spine J 12:356–360PubMedCrossRef
16.
go back to reference Grados F, Depriester C, Cayrolle G et al (2000) Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheumatology 39:1410–1414PubMedCrossRef Grados F, Depriester C, Cayrolle G et al (2000) Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheumatology 39:1410–1414PubMedCrossRef
17.
go back to reference Layton KF, Thielen KR, Koch CA et al (2007) Vertebroplasty, first 1000 levels of a single center: evaluation of the outcomes and complication. Am J Neuroradiol 28:683–689PubMed Layton KF, Thielen KR, Koch CA et al (2007) Vertebroplasty, first 1000 levels of a single center: evaluation of the outcomes and complication. Am J Neuroradiol 28:683–689PubMed
18.
go back to reference Kayanja MM, Schlenk R, Togawa D et al (2006) The biomechanics of 1, 2 and 3 levels of vertebral augmentation with polymethylmethacrylate in multilevel spinal segments. Spine 31:769–774PubMedCrossRef Kayanja MM, Schlenk R, Togawa D et al (2006) The biomechanics of 1, 2 and 3 levels of vertebral augmentation with polymethylmethacrylate in multilevel spinal segments. Spine 31:769–774PubMedCrossRef
19.
go back to reference Choe DH, Marom EM, Ahrar K et al (2004) Pulmonary embolism of polymethyl methacrylate during percutaneous vertebroplasty and kyphoplasty. AJR 183:1097–1102PubMed Choe DH, Marom EM, Ahrar K et al (2004) Pulmonary embolism of polymethyl methacrylate during percutaneous vertebroplasty and kyphoplasty. AJR 183:1097–1102PubMed
20.
go back to reference Ratliff J, Nguyen T, Heiss J (2001) Root and spinal cord compression from methylmethacrylate vertebroplasty. Spine 26:300–302CrossRef Ratliff J, Nguyen T, Heiss J (2001) Root and spinal cord compression from methylmethacrylate vertebroplasty. Spine 26:300–302CrossRef
21.
go back to reference Moreland DB, Landi MK, Grand W (2001) Vertebroplasty: techniques to avoid complications. Spine J 1:66–71PubMedCrossRef Moreland DB, Landi MK, Grand W (2001) Vertebroplasty: techniques to avoid complications. Spine J 1:66–71PubMedCrossRef
22.
go back to reference Mousavi P, Roth S, Finkelstein J et al (2003) Volumetric quantification of cement leakage following percutaneous vertebroplasty in metastatic and osteoporotic vertebrae. J Neurosurg 99:56–59PubMed Mousavi P, Roth S, Finkelstein J et al (2003) Volumetric quantification of cement leakage following percutaneous vertebroplasty in metastatic and osteoporotic vertebrae. J Neurosurg 99:56–59PubMed
23.
go back to reference Ramos L, de Las Heras JA, Sanchez S et al (2006) Medium-term results of percutaneous vertebroplasty in multiple myeloma. Eur J Haematol 77:7–13PubMedCrossRef Ramos L, de Las Heras JA, Sanchez S et al (2006) Medium-term results of percutaneous vertebroplasty in multiple myeloma. Eur J Haematol 77:7–13PubMedCrossRef
24.
go back to reference Barragan-Campos HM, Vallee JN, Lo D et al (2006) Percutaneous vertebroplasty for spinal metastases: complications. Radiology 238:354–362PubMedCrossRef Barragan-Campos HM, Vallee JN, Lo D et al (2006) Percutaneous vertebroplasty for spinal metastases: complications. Radiology 238:354–362PubMedCrossRef
25.
go back to reference Krauss M, Hirschfelder H, Tomandl B et al (2006) Kyphosis reduction and the rate of cement leaks after vertebroplasty of intravertebral clefts. Eur Radiol 16:1015–1021PubMedCrossRef Krauss M, Hirschfelder H, Tomandl B et al (2006) Kyphosis reduction and the rate of cement leaks after vertebroplasty of intravertebral clefts. Eur Radiol 16:1015–1021PubMedCrossRef
26.
go back to reference Hulme PA, Krebs J, Ferguson SJ et al (2006) Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine 31:1983–2001PubMedCrossRef Hulme PA, Krebs J, Ferguson SJ et al (2006) Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine 31:1983–2001PubMedCrossRef
27.
go back to reference Syed MI, Patel NA, Jan S et al (2005) New symptomatic vertebral compression fractures within a year following vertebroplasty in osteoporotic women. Am J Neuroradiol 26:1601–1604PubMed Syed MI, Patel NA, Jan S et al (2005) New symptomatic vertebral compression fractures within a year following vertebroplasty in osteoporotic women. Am J Neuroradiol 26:1601–1604PubMed
28.
go back to reference Voormolen MH, Lohle PN, Juttmann JR et al (2006) The risk of new osteoporotic vertebral compression fractures in the year after percutaneous vertebroplasty. J Vasc Interv Radiol 17:71–76PubMedCrossRef Voormolen MH, Lohle PN, Juttmann JR et al (2006) The risk of new osteoporotic vertebral compression fractures in the year after percutaneous vertebroplasty. J Vasc Interv Radiol 17:71–76PubMedCrossRef
Metadata
Title
Percutaneous vertebroplasty in 1,253 levels: results and long-term effectiveness in a single centre
Authors
Salvatore Masala
Roberta Mastrangeli
Maria Chiara Petrella
Francesco Massari
Antonio Ursone
Giovanni Simonetti
Publication date
01-01-2009
Publisher
Springer-Verlag
Published in
European Radiology / Issue 1/2009
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-008-1133-4

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