Is Redo Vertebroplasty an Effective Treatment on the Same Vertebra?

Cardiovasc Intervent Radiol. 2018 Jul;41(7):1058-1066. doi: 10.1007/s00270-018-1920-5. Epub 2018 Mar 6.

Abstract

Objective: Redo vertebroplasty is rarely reported. Previous studies on redo vertebroplasty included a small number of patients and lacked radiographic analysis. The purpose of this study was to assess the radiographic outcomes (restoration of vertebral body) and clinical outcomes (pain relief) in patients with recurrent or unrelieved pain after vertebroplasty with a minimum follow-up duration of 12 months.

Materials and methods: The records of 22 patients (23 cases), who underwent redo vertebroplasty between March 2001 and February 2014, were analyzed. Vertebral height loss (VHL) and wedge angle (WA) were measured before and after redo vertebroplasty. Subjective back pain was assessed via the numeric rating scale (NRS) score.

Results: VHL after the initial vertebroplasty was 18.7%. Preoperative and final VHL of redo vertebroplasty were 32.3 and 18.3%, respectively. WA after initial vertebroplasty was 9.5°. Preoperative and final WA of redo vertebroplasty was 13.9° and 9°, respectively. Changes of VHL and WA values at each time point were significant (p < 0.01). The change of NRS pain score at each time point, including the period between post-initial vertebroplasty and final follow-up, was statistically significant (p < 0.01); 18 patients (82%) showed marked pain relief and 4 patients (18%) showed partial pain relief.

Conclusions: Redo vertebroplasty seems to be an effective way to achieve pain relief and vertebral body height restorations without major complications in patients with unrelieved or recurrent back pain after vertebroplasty.

Level of evidence: Level 4, case series.

Keywords: Back pain; Cementation; Osteoporotic fracture; Redo vertebroplasty; Vertebroplasty.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Back Pain / etiology
  • Back Pain / therapy
  • Female
  • Fractures, Compression / complications
  • Fractures, Compression / diagnostic imaging
  • Fractures, Compression / therapy*
  • Humans
  • Lumbar Vertebrae / surgery
  • Male
  • Middle Aged
  • Radiography
  • Retreatment
  • Retrospective Studies
  • Spinal Fractures / complications
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / therapy*
  • Thoracic Vertebrae / diagnostic imaging
  • Treatment Outcome
  • Vertebroplasty / methods*