RT Journal Article
SR Electronic
T1 Comparative Study of Percutaneous Vertebral Body Perforation and Vertebroplasty for the Treatment of Painful Vertebral Compression Fractures
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A2847
A1 K. Yokoyama
A1 M. Kawanishi
A1 M. Yamada
A1 H. Tanaka
A1 Y. Ito
A1 M. Hirano
A1 T. Kuroiwa
YR 2011
UL http://www.ajnr.org/content/early/2011/12/22/ajnr.A2847.abstract
AB BACKGROUND AND PURPOSE: Percutaneous vertebral body perforation is a new technique for treating painful VCFs. Herein, we compare the therapeutic effect of vertebral perforation and conventional vertebroplasty for treating VCFs. MATERIALS AND METHODS: One hundred eight patients with single painful VCFs were assigned to undergo vertebral perforation (perforation group) or vertebroplasty (PVP group). Clinical outcomes were assessed by using the VAS. The associations of analgesic effect and clinical factors were also analyzed by multivariate regression. Plain radiographs were used to quantify the progression of vertebral body compression after surgery and to evaluate cement leakage and new vertebral fractures. The median follow-up time was 10 months. RESULTS: Baseline characteristics were similar in the 2 groups. No factors correlated with analgesic effects in the PVP group. The analgesic effect of vertebral perforation was, however, related to the preoperative severity of vertebral compression and was low in patients with severe deformity (P < .05). Among patients with preoperative vertebral percentage of compression below 30%, there were no significant differences between the 2 groups in analgesic effect at any postoperative intervals. Progression of vertebral compression after surgery occurred in 22.2% and 16.0% of treated vertebrae in the perforation and PVP groups, respectively (P = .38). Respectively, 3.7% and 20.0% of the perforation and PVP groups had new postoperative fractures during follow-up (P < .05). There were no other complications. CONCLUSIONS: Vertebral perforation was safe and effective for painful VCFs with slight compression. However, vertebroplasty should be considered for patients with marked vertebral body compression. Abbreviations ADLactivities of daily livingPVPpercutaneous vertebroplastyVASvisual analogue scaleVBHvertebral body heightVCFvertebral body compression fracture