Objective: To evaluate the clinical efficacy and radiological changes in patients with painful osteoporotic vertebral compression fractures (OVCFs) after percutaneous vertebroplasty (PVP).
Methods: Retrospective analysis was conducted on 195 vertebrae in 142 patients with painful OVCFs treated with vertebroplasty in our hospital from May 2007 to June 2012. The scores of visual analogue scale (VAS) were recorded and the heights of vertebral bodies and Cobb angles were measured in the mid-sagittal plane of the reformatted images at 64-detector row CT during the period of follow-up. Polymethylmethacrylate (PMMA) distribution in vertebrae and whether leakage was observed on CT within 3 days after PVP. The changes in VAS, heights of vertebral bodies and Cobb angles were compared between the cases with and without leakages.
Results: The successful rate of technique of PVP was 100%. The mean volume of PMMA injected in each vertebra was (4.5 ± 1.1) ml and (6.0 ± 1.2) ml respectively in thoracic and lumbar. The mean follow-up was (17 ± 6) months. Asymptomatic leakages of PMMA were demonstrated by CT in 38 patients with 43 vertebrae (22.1%). The average decrease in VAS was 5.25 and 1.12 respectively in 24 hours and a month after PVP. The changes in VAS respectively at 1 month, 3 months, 6 months and more than 1 year after procedure were not significantly different.In postoperative 3 days, the average increase in height of vertebral body was 1.55 mm anteriorly and 1.38 mm centrally, the average reduction in Cobb angle were 2.37°. The heights and Cobb angles of vertebral bodies between in 3 days and in more than 1 year after PVP were not significantly different. The scores of VAS and the changes in vertebral body heights and Cobb angles between the patients with or without cement leakages were not significantly different during the period of follow-up.
Conclusion: PVP is an effective treatment for patients with painful OVCFs that provides immediate and sustained pain relief, increases in the heights of vertebral bodies injected in cement and keeps stable radiological progression within at least 1 year after PVP. Asymptomatic cement leakages around vertebrae have no influence on pain relief and vertebral stability in this group of patients.