Clinical outcome and safety of multilevel vertebroplasty: clinical experience and results

Cardiovasc Intervent Radiol. 2013 Feb;36(1):183-91. doi: 10.1007/s00270-012-0379-z. Epub 2012 Jun 27.

Abstract

Purpose: To compare safety and efficacy of percutaneous vertebroplasty (PVP) when treating up to three vertebrae or more than three vertebrae per session.

Materials and methods: We prospectively compared two groups of patients with symptomatic vertebral fractures who had no significant response to conservative therapy. Pathologic substrate included osteoporosis (n = 77), metastasis (n = 24), multiple myeloma (n = 13), hemangioma (n = 15), and lymphoma (n = 1). Group A patients (n = 94) underwent PVP of up to three treated vertebrae (n = 188). Group B patients (n = 36) underwent PVP with more than three treated vertebrae per session (n = 220). Decreased pain and improved mobility were recorded the day after surgery and at 12 and 24 months after surgery per clinical evaluation and the use of numeric visual scales (NVS): the Greek Brief Pain Inventory, a linear analogue self-assessment questionnaire, and a World Health Organization questionnaire.

Results: Group A presented with a mean pain score of 7.9 ± 1.1 NVS units before PVP, which decreased to 2.1 ± 1.6, 2.0 ± 1.5 and 2.0 ± 1.5 NVS units the day after surgery and at 12 and 24 months after surgery, respectively. Group B presented with a mean pain score of 8.1 ± 1.3 NVS units before PVP, which decreased to 2.2 ± 1.3, 2.0 ± 1.5, and 2.1 ± 1.6 NVS units the day after surgery and at 12 and 24 months after surgery, respectively. Overall pain decrease and mobility improvement throughout the follow-up period presented no statistical significance neither between the two groups nor between different underlying aetiology. Reported cement leakages presented no statistical significance between the two groups (p = 0.365).

Conclusion: PVP is an efficient and safe technique for symptomatic vertebral fractures independently of the vertebrae number treated per session.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Bone Cements / therapeutic use
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Fractures, Compression / diagnostic imaging
  • Fractures, Compression / surgery
  • Fractures, Spontaneous / diagnostic imaging
  • Fractures, Spontaneous / surgery
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / adverse effects
  • Minimally Invasive Surgical Procedures / methods
  • Multilevel Analysis
  • Pain Management / methods
  • Pain Measurement
  • Pain, Postoperative / etiology
  • Pain, Postoperative / physiopathology
  • Patient Safety*
  • Prospective Studies
  • Radiography
  • Self-Assessment*
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / surgery*
  • Statistics, Nonparametric
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / surgery
  • Time Factors
  • Treatment Outcome
  • Vertebroplasty / adverse effects
  • Vertebroplasty / methods*

Substances

  • Bone Cements