PT  - JOURNAL ARTICLE
AU  - V.T. Lehman
AU  - L.A. Gray
AU  - D.F. Kallmes
TI  - Percutaneous Vertebroplasty for Painful Compression Fractures in a Small Cohort of Patients with a Decreased Expectation-Related Placebo Effect due to Dementia
AID  - 10.3174/ajnr.A1173
DP  - 2008 Sep 01
TA  - American Journal of Neuroradiology
PG  - 1461--1464
VI  - 29
IP  - 8
4099  - http://www.ajnr.org/content/29/8/1461.short
4100  - http://www.ajnr.org/content/29/8/1461.full
SO  - Am. J. Neuroradiol.2008 Sep 01; 29
AB  - BACKGROUND AND PURPOSE: Although abundant literature has reported success with vertebroplasty for the treatment of painful compression fractures, none has accounted for a potential expectation-related placebo effect. We report the results of vertebroplasty for painful vertebral body compression fractures in a small cohort of patients with dementia with the assumption that this patient subgroup is subjected to a decreased placebo effect.MATERIALS AND METHODS: All patients with objective evidence of dementia (N = 10) who had undergone vertebroplasty at our institution were identified from a comprehensive prospectively constructed vertebroplasty data base. The patients’ pain at rest and activity, mobility, and pain-medication use were analyzed at 2 hours postprocedure, 1 week, 1 month, 6 months, and 1 year.RESULTS: Pain with activity decreased or resolved in 80%–100% of patients at each time point, whereas pain at rest decreased or resolved in 78%–100% of all patients at each time point. Improved mobility was reported in 80%–100% of patients at all time points. Pain medication was decreased or stopped in 67% of patients at 1 week and in 100% of patients at 6 months and 1 year.CONCLUSION: Treatment of painful compression fractures in patients with dementia demonstrates a high rate of success regarding pain relief and mobility. This study offers additional evidence that vertebroplasty has true benefit.