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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 28:555-560, March 2007
© 2007 American Society of Neuroradiology

SPINE

Percutaneous Vertebroplasty Compared with Optimal Pain Medication Treatment: Short-Term Clinical Outcome of Patients with Subacute or Chronic Painful Osteoporotic Vertebral Compression Fractures. The VERTOS Study

M.H.J. Voormolen^a, W.P.T.M. Mali^c, P.N.M. Lohle^a, H. Fransen^e, L.E.H. Lampmann^a, Y. van der Graaf^g, J.R. Juttmann^b, X. Jansssens^f and H.J.J. Verhaar^d

^a Department of Radiology, St Elisabeth Ziekenhuis, Tilburg, the Netherlands
^b Department of Internal Medicine, St Elisabeth Ziekenhuis, Tilburg, the Netherlands
^c Department of Radiology, Universitair Medisch Centrum Utrecht, the Netherlands
^d Department of Geriatric Medicine, Universitair Medisch Centrum Utrecht, the Netherlands
^e Departments of Radiology, Algemeen Ziekenhuis St Lucas, Gent, Belgium
^f Department of Rheumatology, Algemeen Ziekenhuis St Lucas, Gent, Belgium
^g Department of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, Utrecht, the Netherlands

Address correspondence to Maurits Voormolen, MD, Department of Radiology, St Elisabeth Ziekenhuis, PO Box 90151, 5000 LC Tilburg, the Netherlands; e-mail: mhjvoorm{at}12move.nl; maurits.voormolen{at}uza.be

PURPOSE: To prospectively assess the short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures (VCF) treated with percutaneous vertebroplasty (PV) compared with optimal pain medication (OPM).

METHODS: Randomization of patients in 2 groups: treatment by PV or OPM. After 2 weeks, patients from the OPM arm could change therapy to PV. Patients were evaluated 1 day and 2 weeks after treatment. Visual analog score (VAS) for pain and analgesic use were assessed before, and 1 day and 2 weeks after start of treatment. Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) and Roland-Morris Disability (RMD) questionnaire scores were assessed before and 2 weeks after start of treatment. Follow-up scores in patients requesting PV treatment after 2 weeks OPM treatment were compared with scores during their OPM period.

RESULTS: Eighteen patients treated with PV compared with 16 patients treated with OPM had significantly better VAS and used less analgesics 1 day after treatment. Two weeks after treatment, the mean VAS was less but not significantly different in patients treated with OPM, whereas these patients used significantly less analgesics and had better QUALEFFO and RMD scores. Scores in the PV arm were influenced by occurrence of new VCF in 2 patients. After 2 weeks OPM, 14 patients requested PV treatment. All scores, 1 day and 2 weeks after PV, were significantly better compared with scores during conservative treatment.

CONCLUSION: Pain relief and improvement of mobility, function, and stature after PV is immediate and significantly better in the short term compared with OPM treatment.

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