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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 28:563-566, March 2007
© 2007 American Society of Neuroradiology

SPINE

Outcomes of Patients Receiving Long-Term Corticosteroid Therapy Who Undergo Percutaneous Vertebroplasty

C.A. Koch^b, K.F. Layton^a and D.F. Kallmes^a

^a Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minn
^b Mayo Clinic College of Medicine, Rochester, Minn

Address correspondence to David F. Kallmes, MD, Department of Radiology, Mayo Clinic College of Medicine, 200 1st SW, Rochester, MN 55905; e-mail: kallmes.david{at}mayo.edu

BACKGROUND AND PURPOSE: The purpose of this study was to determine the efficacy and rate of complications in patients undergoing percutaneous vertebroplasty (PVP) for vertebral compression fractures as a result of secondary osteoporosis caused by long-term corticosteroid use compared with patients with primary osteoporosis treated with PVP.

MATERIALS AND METHODS: A retrospective review of all patients undergoing PVP was conducted to identify patients who also received long-term corticosteroid therapy. Outcomes including pain, periprocedural complications, and frequency of new fractures in patients receiving corticosteroids were compared with control patients undergoing PVP for primary osteoporosis.

RESULTS: Sixty-eight patients receiving long-term corticosteroid therapy underwent 79 PVP procedures. Patients treated with corticosteroids undergoing PVP were significantly younger and more likely to be male compared with control subjects. Patients receiving long-term corticosteroid treatment experienced significant pain relief immediately postprocedure and at 1 week, 1 month, 6 months, 1 year and 2 years postprocedure (P < .0001 at all time points). Patients receiving corticosteroids experienced similar decreases in pain from baseline compared with control subjects at all follow-up time points (P > .05). The complication rate for patients receiving corticosteroids was 4.4% compared with 3.4% for control subjects (P = .60). Patients on long-term corticosteroid treatment did not have an increased risk of new fractures after PVP compared with control subjects (P = .68).

CONCLUSIONS: Percutaneous vertebroplasty performed for vertebral compression fractures as a result of long-term corticosteroid therapy is as safe and effective in relieving pain as PVP performed in patients with vertebral compression fractures as a result of primary osteoporosis.

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