Twelve-Months Follow-up in Forty-Nine Patients With Acute/Semiacute Osteoporotic Vertebral Fractures Treated Conservatively or With Percutaneous Vertebroplasty
- 1 March 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Spine
- Vol. 35 (5), 478-482
- https://doi.org/10.1097/brs.0b013e3181b71bd1
Abstract
Clinical randomized study. Percutaneous vertebroplasty is compared to conservative treatment in patients with acute or subacute osteoporotic vertebral fractures with respect to pain, physical and mental outcomes. The risk of vertebral fractures adjacent to treated levels is assessed. There are some disagreements of the benefits of PVP for the treatment of acute osteoporotic vertebral fractures, but the long-term clinical outcome of PVP compared to conservative treatment has not been evaluated in a randomized study. The 3-months follow-up of this study has been published previously, and here we report the completed 12-months analysis. About 50 patients (41 females) were included from January 2001 until January 2008. Patients with vertebral fractures less than 8 weeks old were included and randomized to either PVP or conservative treatment. Pain was assessed with a visual analogue scale. Physical and mental outcomes were assessed by validated questionnaires and tests. Tests, questionnaires, and plain radiographs were performed at the inclusion and after 3 and 12 months. Pain score before and after the operation in the PVP group was 7.9 and 2.0, respectively. There was no difference between the groups concerning pain at the 3- and 12-months follow-up. Supplementary assessment of back pain 1 month after discharge from hospital showed a significant lower VAS score in the PVP group over the conservative group. In the study period, 2 adjacent fractures in the PVP group and no adjacent fractures in the conservative group were registered. PVP is a good treatment for some patients with acute/subacute painful osteoporotic vertebral fractures, but the majority of fractures will heal after 8 to 12 weeks of conservative treatment with subsequent decline in pain. The risk of new fractures needs further research.Keywords
This publication has 17 references indexed in Scilit:
- Osteoporotic compression fractures of the spine; current options and considerations for treatmentThe Spine Journal, 2006
- Vertebroplasty: a promising but as yet unproven intervention for painful osteoporotic spinal fractures.The Medical Journal of Australia, 2006
- Percutaneous VertebroplastySpine, 2006
- Percutaneous vertebroplasty: An updateSeminars in Ultrasound, CT and MRI, 2005
- Vertebroplasty and kyphoplasty: a comprehensive reviewNeurosurgical Focus, 2005
- Management of acute osteoporotic vertebral fractures: a nonrandomized trial comparing percutaneous vertebroplasty with conservative therapyThe American Journal of Medicine, 2003
- Occurrence of New Vertebral Body Fracture after Percutaneous Vertebroplasty in Patients with OsteoporosisRadiology, 2003
- Percutaneous vertebroplasty: A to ZTechniques in Vascular and Interventional Radiology, 2002
- Prospective Evaluation of Pain Relief in 100 Patients Undergoing Percutaneous Vertebroplasty: Results and Follow-upJournal of Vascular and Interventional Radiology, 2002
- Vertebroplasty in OsteoporosisSeminars in Musculoskeletal Radiology, 2002