Japanese study shows vertebroplasty provides long-term pain relief for osteoporotic compression fractures

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A study published in the American Journal of Roentgenology has shown that percutaneous vertebroplasty is effective in relieving the pain associated with osteoporosis-induced vertebral compression fractures, and its analgesic effect was shown to last to nearly three years when no new fractures occurred. However, the study also showed that radiologic follow-up observation revealed that new vertebral compression fractures occurred in approximately one-third of the patients.

Naboru Tanigawa, Department of Radiology, Kansai Medical University, Hirakata Hospital, Osaka, Japan and colleagues set out to evaluate the technical and clinical outcomes of 194 patients with 500 osteoporotic vertebral compression fractures consecutively treated by percutaneous vertebroplasty, to investigate the long-term efficacy of percutaneous vertebroplasty, and to determine the frequency of new vertebral compression fractures after percutaneous vertebroplasty.


The investigators enrolled 194 (168 women and 26 men; mean age, 73.3 years; range, 44–89 years) with 500 vertebral compression fractures (T5–L5) in the study. Follow-up was carried out at one day, one month, four months, one year, and then once yearly.

 

Follow-up evaluation included pain response by using a pain visual analog scale (VAS) and frontal and lateral radiographs of the thoracic and lumbar vertebrae regardless of the symptoms.


Tanigawa suggested that “New compression fractures should be considered if recurrence of pain occurred after vertebroplasty.


Results:


  • The investigators say that the mean volume of cement injected was 3.3mL (range,0.5–12 mL) per level.
  • There was leakage of cement in 42.6% of cases (213 levels).
  • The mean follow-up time was 31 months (range, 1–97months).
  • The mean visual analog scale was 7.6 before percutaneous vertebroplasty  and 3.1 at one day, 2.3 at one month, 1.7 at four months, 1.5 at one year, 1.2 at two years, 1 at three years, 1.1 at four years, 0.9 at five years, 0.9 at six years, and 1 at seven years after the procedure.
  • New vertebral compression fractures were confirmed in 103 vertebrae in 33.5% of cases (65 patients), affecting 63.1% adjacent vertebrae (65) and 36.9% (38) non-adjacent vertebrae.