Treatment of chronic symptomatic vertebral compression fractures with percutaneous vertebroplasty.

Brown DB, Gilula LA, Sehgal M, Shimony JS
AJR Am J Roentgenol. 2004 182 (2): 319-22

PMID: 14736654 · DOI:10.2214/ajr.182.2.1820319

OBJECTIVE - Most fractures treated with percutaneous vertebroplasty are subacute and less than 1 year old. We report our experience treating chronic vertebral fractures with vertebroplasty.

MATERIALS AND METHODS - Our database identified 41 patients with symptomatic fractures more than 1 year old. These patients were categorized into subgroups determined by fracture age: 12 months 1 day-24 months (n = 16) or more than 24 months 1 day (n = 25). Changes in pain and mobility for the study group were compared with those in 49 patients with fractures less than 1 year old.

RESULTS - Thirty-three (80%) of the 41 patients in the study group had improvement in pain-seven (17%) had complete and 26 (63%) had partial relief. Forty-five (92%) of the 49 control group patients had improvement in pain-24 (49%) had complete and 21 (43%) had partial relief. The number of patients achieving partial or complete relief of pain was not statistically different between groups (p > 0.05), although complete relief was significantly more frequent in the control group (p = 0.002). Twenty patients (49%) in the study group versus 34 patients (69%) in the control group had improved mobility after vertebroplasty (p = 0.047). Patients with fractures 12 months 1 day-24 months old had improvement in mobility similar to that in patients in the control group (p = 0.962). Fractures more than 24 months 1 day old were associated with significantly less improvement in mobility (p = 0.006).

CONCLUSION - Most patients with fractures more than 1 year old will experience clinical benefit from vertebroplasty. Complete relief of pain is more likely when less mature fractures are treated.

MeSH Terms (20)

Adult Aged Aged, 80 and over Back Pain Bone Cements Chronic Disease Cohort Studies Female Humans Injections, Spinal Lumbar Vertebrae Male Methylmethacrylate Middle Aged Recovery of Function Retrospective Studies Spinal Fractures Thoracic Vertebrae Time Factors Treatment Outcome

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