Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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The Relationship between the Compression Grade of Vertebrae and Outcome after Percutaneous Vertebroplasty in Patients with Osteoporotic Vertebral Compression Fractures

  • Kim, Jung-Min (Department of Neurosurgery, Cheongju Saint Mary's Hospital) ;
  • Lee, Jong-Won (Department of Neurosurgery, Cheongju Saint Mary's Hospital) ;
  • Hur, Jin-Woo (Department of Neurosurgery, Cheongju Saint Mary's Hospital) ;
  • Kim, Seung-Hyun (Department of Neurosurgery, Cheongju Saint Mary's Hospital) ;
  • Lee, Hyun-Koo (Department of Neurosurgery, Cheongju Saint Mary's Hospital) ;
  • Kim, Myoung-Soo (Department of Neurosurgery, Seoul Paik Hospital, Inje University College of Medicine)
  • Published : 2005.11.28
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Abstract

Objective : The aim of this study is to assess the immediate and long-term efficacy of percutaneous vertebroplasty for treating painful vertebral osteoporotic fractures. Methods : A retrospective review of 149patients who had undergone 167 vertebroplasty procedures for osteoporotic fractures was performed. Clinical, radiologic, and procedural datas were analyzed as parameters of prognostic significance, including age, sex, bone marrow density score, symptom duration, bone cement filling grade, number of fractured vertebrae, compression grade of vertebrae, leakage of bone cement, volume of bone cement injected and complications. Results : In 158 of the 167 procedures assessed, immediate pain relief was obtained [94.6%]. The extent of collapse of the vertebral body was assessed as a parameter for prognostic significance [p=0.015]. Three months postoperatively, no improvement of the pain was observed in four of the 167 procedures that had undergone the vertebroplasty [2%]. At long-term follow-up, the improvement of pain was not correlated with the compression grade of vertebrae [p=0.420]. Conclusion : The immediate outcome of vertebroplasty are less effective in vertebrae more collapsed.

Keywords

References

  1. Alvarez L, Perez-Higueras A, Granizo JJ, Miguel LD, Quinones D, Rossi RE : Predictors of outcomes of percutaneous vertebroplasty for osteoporotic vertebral fractures. Spine 30 : 87-92, 2005 https://doi.org/10.1097/00007632-200501010-00016
  2. Barr JD, Barr MS, Lemley TJ, McCann RM : Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 25 : 923-928, 2000 https://doi.org/10.1097/00007632-200004150-00005
  3. Cortet B, Cotten A, Boutry N, Flipo RM, Duquesnoy B, Chastanet P, et al : Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures : an open prospective study. J Rheumatol 26 : 2222-2228, 1999
  4. Cyteval C, Sarrabere MP, Roux JO, Thomas E, Jorgensen C, Blotman F, et al : Acute osteoporotic vertebral collapse : open study on percutaneous injection of acrylic surgical cement in 20patients. AJR Am J Roentgenol 173 : 1685-1690, 1999 https://doi.org/10.2214/ajr.173.6.10584820
  5. Deramond H, Depriester C, Galibert P, Le Gars D : Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. Radiol Clin North Am 36 : 533-546, 1998 https://doi.org/10.1016/S0033-8389(05)70042-7
  6. Deramond H, Depriester C, Toussaint P, Galibert P : Percutaneous vertebroplasty. Semin Musculoskelet Radiol 1 : 285-296, 1997 https://doi.org/10.1055/s-2008-1080150
  7. Eck JC, Hodges SD, Humphreys SC : Vertebroplasty : a new treatment strategy for osteoporotic compression fractures. Am J Orthop 31 : 123- 127, 2002 https://doi.org/10.1007/s00132-002-0302-4
  8. Genant HK, Wu CY, van Kuijk C, Nevitt MC : Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8 : 1137- 1148, 1993 https://doi.org/10.1002/jbmr.5650080915
  9. Grados F, Depriester C, Cayrolle G, Hardy N, Deramond H, Fardellone P : Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheumatology (Oxford) 39 : 1410- 1414, 2000 https://doi.org/10.1093/rheumatology/39.12.1410
  10. Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion JE : Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures : technical aspects. AJNR Am J Neuroradiol 18 : 1897-1904, 1997
  11. Kaufmann TJ, Jensen ME, Schweickert PA, Marx WF, Kallmes DF : Age of fracture and clinical outcomes of percutaneous vertebroplasty. AJNR Am J Neuroradiol 22 : 1860-1863, 2001
  12. Kim MS, Hur JW, Lee JW, Lee HK : Percutaneous Vertebroplasty in Osteoporotic Compression Fracture ; The Degree of Vertebral Compression and Outcome. J Korean Neurosurg Soc 34 : 329-333, 2003
  13. Kim SH, Lee WS, Seo EK, Shin YS, Zhang HY, Jeon P : The Value of Preoperative MRI and Bone Scan in Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures. J Korean Neurosurg Soc 30 : 907-915, 2001
  14. Levine SA, Perin LA, Hayes D, Hayes WS : An evidence-based evaluation of percutaneous vertebroplasty. Manag Care 9 : 56-60, 2000
  15. Liliang PC, Su TM, Liang CL, Chen HJ, Tsai YD, Lu K : Percutaneous vertebroplasty improves pain and physical functioning in elderly osteoporotic vertebral compression fracture patients. Gerontology 51 : 34-39, 2005 https://doi.org/10.1159/000081432
  16. Martin JB, Jean B, Sugiu K, San Millan Ruiz D, Piotin M, Murphy K, et al : Vertebroplasty : clinical experience and follow-up results. Bone 25 (Suppl 2) : 11S-15S, 1999 https://doi.org/10.1016/S8756-3282(99)00126-X
  17. Mathis JM, Barr JD, Belkoff SM, Barr MS, Jensen ME, Deramond H : Percutaneous vertebroplasty : a developing standard of care for vertebral compression fractures. AJNR Am J Neuroradiol 22 : 373-381, 2001
  18. Maynard AS, Jensen ME, Schweickert PA, Marx WF, Short JG, Kallmes DF : Value of bone scan imaging in predicting pain relief from percutaneous vertebroplasty in osteoporotic vertebral fractures. AJNR Am J Neuroradiol 21 : 1807-1812, 2000
  19. Melzack R : The McGill Pain Questionnaire: major properties and scoring methods. Pain 1 : 277-299, 1975 https://doi.org/10.1016/0304-3959(75)90044-5
  20. Ryan PJ, Blake G, Herd R, Fogelman I : A clinical profile of back pain and disability in patients with spinal osteoporosis. Bone 15 : 27-30, 1994 https://doi.org/10.1016/8756-3282(94)90887-7
  21. Ryu KS, Park CK, Kim MC, Kang JK : Dose-dependent epidural leakage of polymethylmethacrylate after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures. J Neurosurg 96 (Suppl 1) : 56-61, 2002
  22. Winking M, Stahl JP, Oertel M, Schnettler R, Boker DK. : Treatment of pain from osteoporotic vertebral collapse by percutaneous PMMA vertebroplasty. Acta Neurochir (Wien) 146 : 469-476, 2004 https://doi.org/10.1007/s00701-004-0259-7
  23. Yu SW, Lee PC, Ma CH, Chuang TY, Chen YJ : Vertebroplasty for the treatment of osteoporotic compression spinal fracture : comparison of remedial action at different stages of injury. J Trauma 56 : 629-632, 2004 https://doi.org/10.1097/01.TA.0000053471.73514.2E