Medial Branch Block Versus Vertebroplasty for 1-Level Osteoporotic Vertebral Compression Fracture: 2-Year Retrospective Study

World Neurosurg. 2019 Feb:122:e1599-e1605. doi: 10.1016/j.wneu.2018.11.142. Epub 2018 Nov 24.

Abstract

Objective: Percutaneous vertebroplasty (VP) and medial branch block (MBB) are used to treat osteoporotic vertebral compression fractures (VCF). We compared the clinical outcomes, radiologic changes, and economic results of MBB with those of VP in treating osteoporotic VCFs.

Methods: A total of 164 patients with 1-level osteoporotic VCF were reviewed retrospectively. The clinical outcomes were measured with a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). To compare economic costs between groups, total hospital costs at the last follow-up day were calculated.

Results: The patients were divided into 2 groups: 72 patients in the conservative group treated by MBB (MBB group) and 92 patients in the group who underwent VP (VP group). The VAS and ODI scores improved significantly within postoperative week 1 in the VP group compared with the MBB group. However, the VAS and ODI scores did not differ between the groups after 1 postoperative year. After 2 years of follow-up, 14 new fractures occurred in the VP group and 3 in the MBB group. The improvement in compression ratio was statistically greater in the VP group than in the MBB group. However, after 2 years the radiologic changes between groups did not differ statistically. After the final follow-up visits, the hospital costs were significantly lower in the MBB group.

Conclusions: After 2 years of follow-up, VP and MBB both had similar efficacy in terms of pain relief and radiologic changes. MBB was more cost effective than VP. Thus, MBB alone can be a possible alternative to VP in patients with 1-level osteoporotic VCFs.

Keywords: Medial branch block; Osteoporosis; Vertebral compression fracture; Vertebroplasty.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Conservative Treatment / economics
  • Female
  • Follow-Up Studies
  • Fractures, Compression / diagnostic imaging
  • Fractures, Compression / economics
  • Fractures, Compression / therapy*
  • Health Care Costs
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / injuries
  • Lumbar Vertebrae / surgery
  • Male
  • Middle Aged
  • Nerve Block* / economics
  • Osteoporotic Fractures / diagnostic imaging
  • Osteoporotic Fractures / economics
  • Osteoporotic Fractures / therapy*
  • Pain Measurement
  • Retrospective Studies
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / economics
  • Spinal Fractures / therapy*
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / injuries
  • Thoracic Vertebrae / surgery
  • Treatment Outcome
  • Vertebroplasty* / economics