American Journal of Neuroradiology 2009;30:323.
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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1356
SPINE
Vertebroplasty for the Treatment of Traumatic Nonosteoporotic Compression Fractures
From the Department of Radiology (K.R.T., D.F.K.), Mayo Clinic, Rochester, Minn; and the University of Wisconsin School of Medicine and Public Health (E.M.K.), Madison, Wis.
Please address correspondence to David F. Kallmes, MD, Mayo Clinic, Department of Radiology, 200 1st St SW, Rochester, MN 55905; e-mail: kallmes.david{at}mayo.edu
BACKGROUND AND PURPOSE: Vertebroplasty is commonly used for osteoporotic and neoplastic compression fractures, yet little evidence exists for its use in traumatic nonosteoporotic compression fractures. The purpose of this study was to evaluate the safety and efficacy of percutaneous vertebroplasty for patients with traumatic nonosteoporotic compression fractures.
MATERIALS AND METHODS: We performed a retrospective review of 819 patients (982 procedures) who underwent percutaneous vertebroplasty, to identify patients who had normal bone mineral densitometry scores or had no previous diagnosis of osteoporosis, multiple myeloma, or history of long-term steroid use. Follow-up evaluations included pain at rest and with activity (assessed with the visual analog scale [VAS]), medication use, and mobility. Roland-Morris Disability Questionnaire (RDQ) scores were also collected. Statistical analysis included a 2-tailed t test comparing postprocedure outcomes with baseline values.
RESULTS: Fifteen patients (53% women) were included. Mean age and t-score were 60 years and –0.35, respectively. We found significant improvements in the VAS scores, both at rest and with activity, and in the RDQ scores, starting at the 2-hour follow-up. Additionally, we found marked decreases in medication use and improvements in mobility. The complication rate was low and characterized by asymptomatic extravasation of cement.
CONCLUSIONS: From our study, we have shown that vertebroplasty can be successfully and safely used in patients with traumatic nonosteoporotic compression fractures. Vertebroplasty in these patients should be used after failure of conservative treatments and may be used in place of more invasive spinal reconstruction techniques.