Interventional techniques in managing persistent pain after vertebral augmentation procedures: a retrospective evaluation

Pain Physician. 2007 Sep;10(5):673-6.

Abstract

Background: Based on systematic reviews, it appears that at least 10% of patients may continue to suffer with residual or persistent pain after successful vertebral or sacral augmentation procedures.

Objective: To report and evaluate the incidence and prevalence of different spinal injections in patients who received vertebroplasty, kyphoplasty, and sacroplasty procedures for both benign and malignant compression fractures.

Design: A retrospective case review.

Methods: Retrospective review of all cases of vertebroplasty, sacroplasty, and kyphoplasty performed in a 12-month period in a single outpatient setting of interventional radiology was conducted.

Results: In a 12-month period starting from October 2005 to September 2006, 144 patients underwent cement augmentation procedures. Of the 144, 34 patients required a spinal injection procedure for residual or persistent pain within a 1-year period after the augmentation procedure. Twenty-four patients required epidural steroid injections, 6 patients required intercostal nerve blocks, 5 patients required trigger point injections, 5 patients required sacroiliac joint injections, and 1 patient required facet joint injections. Nine patients who required lumbar epidural steroid injections and all patients who required intercostal nerve blocks and had underwent a thoracic cement augmentation procedure.

Conclusion: A small proportion of patients undergoing percutaneous cement augmentation for vertebral compression fractures or sacral insufficiency fractures potentially require spinal injections to treat residual pain after the procedure.

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Aged
  • Aged, 80 and over
  • Female
  • Fractures, Compression / surgery
  • Humans
  • Injections, Spinal
  • Male
  • Middle Aged
  • Nerve Block
  • Pain / etiology*
  • Pain Management*
  • Retrospective Studies
  • Vertebroplasty / adverse effects*

Substances

  • Adrenal Cortex Hormones