Percutaneous vertebroplasty for symptomatic osteoporotic compression fractures: A single-center prospective study

Surg Neurol Int. 2021 Apr 19:12:176. doi: 10.25259/SNI_212_2021. eCollection 2021.

Abstract

Background: Osteoporotic vertebral compression fractures (OVCFs) increasingly occur with advancing age, and are associated with significant morbidity, mortality, and cost. We assessed the clinical efficacy, radiological, and functional outcomes for patients undergoing percutaneous vertebroplasty (PVP) due to OVCFs, with a special focus on the frequency of new vertebral compression fractures (VCFs).

Methods: This study, carried from 2018 to 2020, included 22 females and 4 males. They averaged 60.15 years of age (range, 50-70) were followed an average of 14.5 months (range 12-36 months), and had 30 VCFs between the T7-L2 levels. Multiple variables were studied, including; anterior vertebral height (AVH) and kyphotic angle (KA), new VCFs, and functional outcomes.

Results: The postoperative Visual Analog Scale and Oswestry Disability Index were significantly reduced at 12 months after PVP. Improvements for AVH and KA were also statistically significant; 23 patients (88.46%) had a dramatic decrease in pain on post-operative day 1, while 3 patients (11.53%) had no decrease in pain after PVP on post-operative day 1-1 postoperative month. No major complications were observed except high incidence of cement leakage at 8 levels (26.67%) in 6 patients. Additionally, new VCFs occurred in 10 vertebrae in 8 patients (30.76%), involving 6 adjacent (60%), and 4 nonadjacent vertebrae (40%).

Conclusion: PVP is an effective procedure in the management of painful OVCFs refractory to medical treatment. These PVP procedures yield immediate vertebral stabilization, relieve pain, and restore function with minimal associated morbidity.

Keywords: Bone cement; Compression fracture; Osteoporosis; Vertebroplasty.