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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 25:639-641, April 2004
© 2004 American Society of Neuroradiology

SPINE

Treatment Considerations for Vertebroplasty in Men

Alan Hammond^a, Lee H. Riley, III^b, Philippe Gailloud^a, David A. Nussbaum^a, Monica Watkins^a and Kieran J. Murphy^a

^a Division of Interventional Neuroradiology, The Johns Hopkins Medical Institutions, Baltimore, MD
^b Department of Radiology and Radiologic Sciences, and Department of Orthopedic Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD

Address correspondence to Kieran J Murphy, MD, Division of Interventional Neuroradiology, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD 21287

BACKGROUND AND PURPOSE: Vertebroplasty is now a widely accepted image-guided intervention in patients with compression fracture. The purpose of this report is to look specifically at the male population undergoing vertebroplasty and identfy the management considerations distinct to men.

METHODS: The hospital medical records and radiographic studies of 24 men treated with vertebroplasty between February 1999 and November 2000 were retrospectively reviewed.

RESULTS: Five patients presented with idiopathic or secondary osteoporosis. In two of these five men, malignancies were discovered by core biopsies taken at the time of vertebroplasty. Thirteen patients (54%) had secondary osteoporosis. Of this group, 10 patients (42%) were steroid dependent and three (13%) were hypogonadal. Five patients (21%) had traumatic events leading to fracture. One presented with known metastases.

CONCLUSION: Primary osteoporosis in men is unusual. In male patients without a definable cause of osteoporosis, known metastatic disease, or a significant history of trauma, the routine performance of a vertebral biopsy through the vertebroplasty needle before the injection of bone cement is indicated to identify unexpected neoplasm.