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01-02-2019 | Original Article

The safety and efficacy of percutaneous vertebroplasty for patients over 90 years old

Authors: Shunsuke Kamei, Tomoyuki Noguchi, Yoshitaka Shida, Takashi Okafuji, Kota Yokoyama, Fumiya Uchiyama, Hiroshi Nakatake, Tsuyoshi Tajima

Published in: Japanese Journal of Radiology | Issue 2/2019

Abstract

Objective

To retrospectively analyze the safety and efficacy of percutaneous vertebroplasty (PVP) for patients aged 90 or over.

Materials and methods

We analyzed 130 consecutive patients with osteoporotic vertebral fractures who underwent a first-time PVP between May 2015 and September 2017 at our institution. We divided them into the elder patient group aged 90 years or over (n = 21) and the younger patient group under 90 years (n = 109). We compared the two groups’ background, treatments, and outcomes using univariate analyzes and the log rank test.

Results

A significant difference was observed in dementia (19% in the younger group vs. 48% in the elder group, p < 0.01). No significant difference was revealed in the procedure time or the rate of complications. The post-PVP mobility function and the pain level were significantly improved compared to before PVP in both groups (p < 0.01 each). No significant differences were observed between the two groups in the recurrence of vertebral fracture after treatment (17% vs. 14%) or the 1-year survival rate (79% vs. 86%), respectively.

Conclusion

The results of our analyzes suggested that a PVP can safely and effectively contribute to pain relief as well as the restoration of ambulation for patients aged 90 or over.

Shiraki M, Kuroda T, Shiraki Y, Aoki C, Sasaki K, Tanaka S. Effects of bone mineral density of the lumbar spine and prevalent vertebral fractures on the risk of immobility. Osteoporos Int. 2010;21(9):1545–51.CrossRefPubMed

Tsujio T, Nakamura H, Terai H, Hoshino M, Namikawa T, Matsumura A, et al. Characteristic radiographic or magnetic resonance images of fresh osteoporotic vertebral fractures predicting potential risk for nonunion: a prospective multicenter study. Spine (Phila Pa 1976). 2011;36(15):1229–35.CrossRef

Buchbinder R, Osborne RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med. 2009;361(6):557–68.CrossRefPubMed

Kallmes DF, Comstock BA, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH, et al. A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med. 2009;361(6):569–7.CrossRefPubMedCentralPubMed

Boszczyk B. Volume matters: a review of procedural details of two randomised controlled vertebroplasty trials of 2009. Eur Spine J. 2010;19(11):1837–40.CrossRefPubMedCentralPubMed

Clark W, Bird P, Gonski P, Diamond TH, Smerdely P, McNeil HP, et al. Safety and efficacy of vertebroplasty for acute painful osteoporotic fractures (VAPOUR): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet. 2016;388(10052):1408–16.CrossRefPubMed

Yuan WH, Hsu HC, Lai KL. Vertebroplasty and balloon kyphoplasty versus conservative treatment for osteoporotic vertebral compression fractures: a meta-analysis. Medicine. 2016;95(31):e4491.CrossRefPubMedCentralPubMed

Kobayashi N, Numaguchi Y, Fuwa S, Uemura A, Matsusako M, Okajima Y, et al. Prophylactic vertebroplasty: cement injection into non-fractured vertebral bodies during percutaneous vertebroplasty. Acad Radiol. 2009;16(2):136–43.CrossRefPubMed

Shida Y, Noguchi T, Okafuji T, Murakami K, Iraha T, Yokoyama K, et al. Percutaneous vertebroplasty for acute osteoporotic vertebral fracture contributes to restoration of ambulation. Interv Radiol. 2017;2(3):74–8.CrossRef

10.

Tanigawa N, Komemushi A, Kariya S, Kojima H, Shomura Y, Omura N, et al. Relationship between cement distribution pattern and new compression fracture after percutaneous vertebroplasty. AJR Am J Roentgenol. 2007;189(6):W348–W352.CrossRefPubMed

11.

Fujiwara S, Kasagi F, Masunari N, Naito K, Suzuki G, Fukunaga M. Fracture prediction from bone mineral density in Japanese men and women. J Bone Miner Res. 2003;18(8):1547–53.CrossRefPubMed

12.

Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000;15(4):721–39.CrossRefPubMed

13.

Yokoyama K, Kawanishi M, Yamada M, Tanaka H, Ito Y, Hirano M, et al. Validity of intervertebral bone cement infusion for painful vertebral compression fractures based on the presence of vertebral mobility. AJNR Am J Neuroradiol. 2013;34(1):228–32.CrossRefPubMed

14.

Diamond TH, Champion B, Clark WA. Management of acute osteoporotic vertebral fractures: a nonrandomized trial comparing percutaneous vertebroplasty with conservative therapy. Am J Med. 2003;114(4):257–65.CrossRefPubMed

15.

Saracen A, Kotwica Z. Complications of percutaneous vertebroplasty: an analysis of 1100 procedures performed in 616 patients. Medicine. 2016;95(24):e3850.CrossRefPubMedCentralPubMed

16.

Hiwatashi A, Westesson PL, Yoshiura T, Noguchi T, Togao O, Yamashita K, et al. Kyphoplasty and vertebroplasty produce the same degree of height restoration. AJNR Am J Neuroradiol. 2009;30(4):669–73.CrossRefPubMed

17.

Dohm M, Black CM, Dacre A, Tillman JB, Fueredi G. A randomized trial comparing balloon kyphoplasty and vertebroplasty for vertebral compression fractures due to osteoporosis. AJNR Am J Neuroradiol. 2014;35(12):2227–36.CrossRefPubMed

18.

Bednar T, Heyde CE, Bednar G, Nguyen D, Volpi E, Przkora R. Kyphoplasty for vertebral augmentation in the elderly with osteoporotic vertebral compression fractures: scenarios and review of recent studies. Clin Ther. 2013;35(11):1721–7.CrossRefPubMedCentralPubMed

19.

Baumgart M, Snyder HM, Carrillo MC, Fazio S, Kim H, Johns H. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: a population-based perspective. Alzheimer's Dement J Alzheimer's Assoc. 2015;11(6):718–26.CrossRef

20.

Rousing R, Andersen MO, Jespersen SM, Thomsen K, Lauritsen J. Percutaneous vertebroplasty compared to conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures: three-months follow-up in a clinical randomized study. Spine (Phila Pa 1976). 2009;34(13):1349-54.CrossRef

21.

Son S, Lee SG, Kim WK, Park CW, Yoo CJ. Early vertebroplasty versus delayed vertebroplasty for acute osteoporotic compression fracture: are the results of the two surgical strategies the same? J Korean Neurosurg Soc. 2014;56(3):211–7.CrossRefPubMedCentralPubMed

Title: The safety and efficacy of percutaneous vertebroplasty for patients over 90 years old
Authors: Shunsuke Kamei
Tomoyuki Noguchi
Yoshitaka Shida
Takashi Okafuji
Kota Yokoyama
Fumiya Uchiyama
Hiroshi Nakatake
Tsuyoshi Tajima
Publication date: 01-02-2019
Publisher: Springer Japan
Published in: Japanese Journal of Radiology / Issue 2/2019
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI: https://doi.org/10.1007/s11604-018-0797-1

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The safety and efficacy of percutaneous vertebroplasty for patients over 90 years old

Abstract

Objective

Materials and methods

Results

Conclusion

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Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusion

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