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Published in: European Radiology 2/2005

01-02-2005 | Musculoskeletal

Percutaneous vertebroplasty immediately relieves pain of osteoporotic vertebral compression fractures and prevents prolonged immobilization of patients

Authors: Kiyokazu Kobayashi, Keiji Shimoyama, Keiya Nakamura, Kiyoshi Murata

Published in: European Radiology | Issue 2/2005

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Abstract

To assess the immediate efficacy of percutaneous vertebroplasty (PVP) in relief of pain and improving mobility of patients with vertebral compression fractures (VCF) secondary to osteoporosis, 205 cases (175 patients) underwent 250 percutaneous injections of polymethylmethacrylate (PMMA; unilateral, 247 levels; bilateral, 3 levels) into vertebrae under CT and fluoroscopic guidance for 34 months. Patients were prospectively asked to quantify their pain on a visual analog scale (VAS) before and a day after PVP. The interval to mobilization was recorded in those who were immobilized because of pain and/or bed-rest therapy (115 cases). PVP was technically successful in all patients, with three cases of minimal complications. The mean VAS score available for 196 cases was improved from 7.22±1.89 (range, 3–10) to 2.07±1.19 (range, 0–10) by PVP. Ninety-four of 115 immobilized cases (81.7%) were mobile by 24 h after PVP, and the mean value was 1.9±2.8 days. The incidence of recurrent and new fractures was 15.6% in 4–25 months (mean, 15.3 months). PVP is a safe and effective treatment for relieving the pain associated with osteoporotic VCF and strengthening the vertebrae, avoiding refractures. This therapy leads to early mobilization and avoidance of the dangers of conservative therapy of bed-rest.
Literature
1.
go back to reference Ross PD, Fujiwara S, Huang C, Davis JW, Epstein RS, Wasnich RD, Kodama K, Melton LJ III (1995) Vertebral fracture prevalence in women in Hiroshima compared to Caucasians or Japanese in the US. Int J Epidemiol 24:1171–1177PubMed Ross PD, Fujiwara S, Huang C, Davis JW, Epstein RS, Wasnich RD, Kodama K, Melton LJ III (1995) Vertebral fracture prevalence in women in Hiroshima compared to Caucasians or Japanese in the US. Int J Epidemiol 24:1171–1177PubMed
2.
go back to reference Chrischilles E, Shireman T, Wallace R (1994) Costs and health effects of osteoporotic fractures. Bone 15:377–386CrossRefPubMed Chrischilles E, Shireman T, Wallace R (1994) Costs and health effects of osteoporotic fractures. Bone 15:377–386CrossRefPubMed
3.
go back to reference Galibert P, Deramond H, Rosat P, Le Gars D (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty [in French]. Neurochirurgie 33:166–168PubMed Galibert P, Deramond H, Rosat P, Le Gars D (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty [in French]. Neurochirurgie 33:166–168PubMed
4.
go back to reference Debussche-Depriester C, Deramond H, Fardelonne P, Heleg A, Cebert JL, Cartz L, Galibert P (1991) Percutaneous vertebroplasty with acrylic cement in the treatment of osteoporotic vertebral crash fracture syndrome. Neuroradiology 33S:149–152 Debussche-Depriester C, Deramond H, Fardelonne P, Heleg A, Cebert JL, Cartz L, Galibert P (1991) Percutaneous vertebroplasty with acrylic cement in the treatment of osteoporotic vertebral crash fracture syndrome. Neuroradiology 33S:149–152
5.
go back to reference Deramond H, Depriester C, Galibert P, le Gars D (1998) Percutaneous vertebroplasty with polymethylmethacrylate: technique, indications and results. Radiol Clin North Am 36:533–546PubMed Deramond H, Depriester C, Galibert P, le Gars D (1998) Percutaneous vertebroplasty with polymethylmethacrylate: technique, indications and results. Radiol Clin North Am 36:533–546PubMed
6.
go back to reference Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion JE (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of compression fractures: technical aspects. Am J Neuroradiol 18:1897–1904PubMed Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion JE (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of compression fractures: technical aspects. Am J Neuroradiol 18:1897–1904PubMed
7.
go back to reference Mathis JM, Eckel TS, Belkoff SM, Deramond H (1999) Percutaneous vertebroplasty: a therapeutic option for pain associated with vertebral compression fracture. J Back Musculoskeletal Rehabil 13:11–17 Mathis JM, Eckel TS, Belkoff SM, Deramond H (1999) Percutaneous vertebroplasty: a therapeutic option for pain associated with vertebral compression fracture. J Back Musculoskeletal Rehabil 13:11–17
8.
go back to reference Mathis JM, Barr JD, Belkoff SM, Barr MS, Jensen ME, Deramond H (2001) Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. Am J Neuroradiol 22:373–381PubMed Mathis JM, Barr JD, Belkoff SM, Barr MS, Jensen ME, Deramond H (2001) Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. Am J Neuroradiol 22:373–381PubMed
9.
go back to reference Evans AJ, Jensen ME, Kip KE, DeNardo AJ, Lawler GJ, Negin GA, Remley KB, Boutin SM, Dunnagan SA (2003) Vertebral compression fractures: pain reduction and improvement in functional mobility after percutaneous polymethylmethacrylate vertebroplasty—retrospective report of 245 cases. Radiology 226:366–372PubMed Evans AJ, Jensen ME, Kip KE, DeNardo AJ, Lawler GJ, Negin GA, Remley KB, Boutin SM, Dunnagan SA (2003) Vertebral compression fractures: pain reduction and improvement in functional mobility after percutaneous polymethylmethacrylate vertebroplasty—retrospective report of 245 cases. Radiology 226:366–372PubMed
10.
go back to reference Cortet B, Cotten A, Boutry N, Flipo RM, Duquesnoy B, Chastanet P, Delcambre B (1999) Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study. J Rheumatol 26:2222–2228PubMed Cortet B, Cotten A, Boutry N, Flipo RM, Duquesnoy B, Chastanet P, Delcambre B (1999) Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study. J Rheumatol 26:2222–2228PubMed
11.
go back to reference Grados H, Depriester P, Cayrolle G, Hardy N, Deramond H, Fardellone P (2000) Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheumatology (Oxford) 39:1410–1414 Grados H, Depriester P, Cayrolle G, Hardy N, Deramond H, Fardellone P (2000) Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheumatology (Oxford) 39:1410–1414
12.
go back to reference Zoarski GH, Snow P, Olan WJ, Stallmeyer MJ, Dick BW, Hebel JR, De Deyne M (2002) Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. J Vasc Interv Radiol 13:139–148PubMed Zoarski GH, Snow P, Olan WJ, Stallmeyer MJ, Dick BW, Hebel JR, De Deyne M (2002) Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. J Vasc Interv Radiol 13:139–148PubMed
13.
go back to reference Heini PF, Walchli B, Berlemann U (2000) Percutaneous transpedicular vertebroplasty with PMMA: operative technique and early results. A prospective study for the treatment of osteoporotic compression fractures. Eur Spine J 9:445–450CrossRefPubMed Heini PF, Walchli B, Berlemann U (2000) Percutaneous transpedicular vertebroplasty with PMMA: operative technique and early results. A prospective study for the treatment of osteoporotic compression fractures. Eur Spine J 9:445–450CrossRefPubMed
14.
go back to reference Barr JD, Barr MS, Lemley TJ, McCann RM (2000) Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 25:923–928CrossRefPubMed Barr JD, Barr MS, Lemley TJ, McCann RM (2000) Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 25:923–928CrossRefPubMed
15.
go back to reference Peh WC, Gilula la (2003) Percutaneous vertebroplasty: indications, contraindications, and technique. Br J Radiol 76:69–75CrossRefPubMed Peh WC, Gilula la (2003) Percutaneous vertebroplasty: indications, contraindications, and technique. Br J Radiol 76:69–75CrossRefPubMed
16.
17.
go back to reference Haczynski J, Jakimiuk AJ (2001) Vertebral fractures: a hidden problem of osteoporosis. Med Sci Monit 7:1108–1117PubMed Haczynski J, Jakimiuk AJ (2001) Vertebral fractures: a hidden problem of osteoporosis. Med Sci Monit 7:1108–1117PubMed
18.
go back to reference Gangi A, Kastler BA, Dietemann JL (1994) Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. Am J Neuroradiol 15:83–86PubMed Gangi A, Kastler BA, Dietemann JL (1994) Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. Am J Neuroradiol 15:83–86PubMed
19.
go back to reference Cyteval C, Sarrabere MP, Roux JO, Thomas E, Jorgensen C, Blotman F, Sany J, Taourel P (1999) Acute osteoporotic vertebral collapse: open study on percutaneous injection of acrylic surgical cement in 20 patients. Am J Roentgenol 173:1685–1690 Cyteval C, Sarrabere MP, Roux JO, Thomas E, Jorgensen C, Blotman F, Sany J, Taourel P (1999) Acute osteoporotic vertebral collapse: open study on percutaneous injection of acrylic surgical cement in 20 patients. Am J Roentgenol 173:1685–1690
20.
go back to reference Amar AP, Larsen DW, Esnaashari N, Albuquerque FC, Lavine SD, Teitelbaum GP (2001) Percutaneous transpedicular polymethylmethacrylate vertebroplasty for the treatment of spinal compression fractures. Neurosurgery 49:1105–1114CrossRefPubMed Amar AP, Larsen DW, Esnaashari N, Albuquerque FC, Lavine SD, Teitelbaum GP (2001) Percutaneous transpedicular polymethylmethacrylate vertebroplasty for the treatment of spinal compression fractures. Neurosurgery 49:1105–1114CrossRefPubMed
21.
go back to reference Kim AK, Jensen ME, Dion JE, Schweickert PA, Kaufmann TJ, Kallmes DF (2002) Unilateral transpedicular percutaneous vertebroplasty: initial experience. Radiology 222:737–741PubMed Kim AK, Jensen ME, Dion JE, Schweickert PA, Kaufmann TJ, Kallmes DF (2002) Unilateral transpedicular percutaneous vertebroplasty: initial experience. Radiology 222:737–741PubMed
22.
go back to reference Weill A, Chiras J, Simon JM, Rose M, Sola-Martinez T, Enkaoua E (1996) Spinal metastases: indications for and results of percutaneous injection of acrylic surgical cement. Radiology 199:241–247PubMed Weill A, Chiras J, Simon JM, Rose M, Sola-Martinez T, Enkaoua E (1996) Spinal metastases: indications for and results of percutaneous injection of acrylic surgical cement. Radiology 199:241–247PubMed
23.
go back to reference Convery FR, Gunn DR, Hughes JD, Martin WE (1975) The relative safety of polymethylmethacrylate. A controlled clinical study of randomly selected patients treated with Charnley and ring total hip replacements. J Bone Joint Surg Am 57:57–64PubMed Convery FR, Gunn DR, Hughes JD, Martin WE (1975) The relative safety of polymethylmethacrylate. A controlled clinical study of randomly selected patients treated with Charnley and ring total hip replacements. J Bone Joint Surg Am 57:57–64PubMed
24.
go back to reference Ereth MH, Weber JG, Abel MD, Lennon RL, Lewallen DG, Ilstrup DM, Rehder K (1992) Cemented versus noncemented total hip arthroplasty—embolism, hemodynamics, and intrapulmonary shunting. Mayo Clin Proc 67:1066–1074PubMed Ereth MH, Weber JG, Abel MD, Lennon RL, Lewallen DG, Ilstrup DM, Rehder K (1992) Cemented versus noncemented total hip arthroplasty—embolism, hemodynamics, and intrapulmonary shunting. Mayo Clin Proc 67:1066–1074PubMed
25.
go back to reference Modig J, Busch C, Olerud S, Saldeen T, Waernbaum G (1975) Arterial hypotension and hypoxaemia during total hip replacement: the importance of thromboplastic products, fat embolism and acrylic monomers. Acta Anaesthesiol Scand 19:28–43PubMed Modig J, Busch C, Olerud S, Saldeen T, Waernbaum G (1975) Arterial hypotension and hypoxaemia during total hip replacement: the importance of thromboplastic products, fat embolism and acrylic monomers. Acta Anaesthesiol Scand 19:28–43PubMed
26.
go back to reference Rudigier JF, Ritter G (1983) Pathogenesis of circulatory reactions triggered by nervous reflexes during the implantation of bone cements. Res Exp Med (Berl) 183:77–94 Rudigier JF, Ritter G (1983) Pathogenesis of circulatory reactions triggered by nervous reflexes during the implantation of bone cements. Res Exp Med (Berl) 183:77–94
27.
go back to reference Dahl OE, Johnsen H, Kierulf P, Molnar I, Ro JS, Vinje A, Mowinckel P (1992) Intrapulmonary thrombin generation and its relation to monomethylmethacrylate plasma levels during hip arthroplasty. Acta Anaesthesiol Scand 36:331–335PubMed Dahl OE, Johnsen H, Kierulf P, Molnar I, Ro JS, Vinje A, Mowinckel P (1992) Intrapulmonary thrombin generation and its relation to monomethylmethacrylate plasma levels during hip arthroplasty. Acta Anaesthesiol Scand 36:331–335PubMed
28.
go back to reference Kaufmann TJ, Jensen ME, Ford G, Gill LL, Marx WF, Kallmes DF (2002) Cardiovascular effects of polymethylmethacrylate use in percutaneous vertebroplasty. Am J Neuroradiol 23:601–604PubMed Kaufmann TJ, Jensen ME, Ford G, Gill LL, Marx WF, Kallmes DF (2002) Cardiovascular effects of polymethylmethacrylate use in percutaneous vertebroplasty. Am J Neuroradiol 23:601–604PubMed
29.
go back to reference Peh WC, Gilula LA, Peck DD (2002) Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Radiology 223:121–126PubMed Peh WC, Gilula LA, Peck DD (2002) Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Radiology 223:121–126PubMed
30.
go back to reference Cortet B, Cotten A, Boutry N, Dewatre F, Flipo RM, Duquesnoy B, Chastanet P, Delcambre B (1997) Percutaneous vertebroplasty in patients with osteolytic metastases or multiple myeloma. Rev Rhum Engl Ed 64:177–183PubMed Cortet B, Cotten A, Boutry N, Dewatre F, Flipo RM, Duquesnoy B, Chastanet P, Delcambre B (1997) Percutaneous vertebroplasty in patients with osteolytic metastases or multiple myeloma. Rev Rhum Engl Ed 64:177–183PubMed
31.
go back to reference Yeom JS, Kim WJ, Choy WS, Lee CK, Chang BS, Kang JW (2003) Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures. J Bone Joint Surg Br 85:83–89CrossRefPubMed Yeom JS, Kim WJ, Choy WS, Lee CK, Chang BS, Kang JW (2003) Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures. J Bone Joint Surg Br 85:83–89CrossRefPubMed
32.
go back to reference Perez-Higueras A, Alvarez L, Rossi RE, Quinones D, Al-Assir I (2002) Percutaneous vertebroplasty: long-term clinical and radiological outcome. Neuroradiology 44:950–954 Perez-Higueras A, Alvarez L, Rossi RE, Quinones D, Al-Assir I (2002) Percutaneous vertebroplasty: long-term clinical and radiological outcome. Neuroradiology 44:950–954
33.
go back to reference Cotten A, Boutry N, Cortet B, Assaker R, Demondion X, Leblond D, Chastanet P, Duquesnoy B, Deramond H (1998) Percutaneous vertebroplasty: state of the art. Radiographics 18:311–320PubMed Cotten A, Boutry N, Cortet B, Assaker R, Demondion X, Leblond D, Chastanet P, Duquesnoy B, Deramond H (1998) Percutaneous vertebroplasty: state of the art. Radiographics 18:311–320PubMed
34.
go back to reference Uppin AA, Hirsch JA, Centenera LV, Pfiefer BA, Pazianos AG, Choi IS (2003) Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. Radiology 226:119–124PubMed Uppin AA, Hirsch JA, Centenera LV, Pfiefer BA, Pazianos AG, Choi IS (2003) Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. Radiology 226:119–124PubMed
35.
go back to reference Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, Licata A, Benhamou L, Geusens P, Flowers K, Stracke H, Seeman E (2001) Risk of new vertebral fracture in the year following a fracture. J Am Med Assoc 285:320–323CrossRef Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, Licata A, Benhamou L, Geusens P, Flowers K, Stracke H, Seeman E (2001) Risk of new vertebral fracture in the year following a fracture. J Am Med Assoc 285:320–323CrossRef
Metadata
Title
Percutaneous vertebroplasty immediately relieves pain of osteoporotic vertebral compression fractures and prevents prolonged immobilization of patients
Authors
Kiyokazu Kobayashi
Keiji Shimoyama
Keiya Nakamura
Kiyoshi Murata
Publication date
01-02-2005
Publisher
Springer-Verlag
Published in
European Radiology / Issue 2/2005
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-004-2549-0

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