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Percutaneous vertebroplasty: the follow-up

La vertebroplastica percutanea: il follow-up

  • Musculoskeletal Radiology Radiologia Muscoloscheletrica
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

This article reports on our experience treating vertebral fractures with percutaneous vertebroplasty. A clinical and imaging follow-up designed to identify the early (especially pulmonary embolism of bone cement) and late complications of the technique is proposed.

Material and methods

On the basis of the current guidelines, 101 patients were selected: 64 osteoporotic and 37 neoplastic. A total of 173 vertebrae were treated. Procedures were performed with both computed tomography and fluoroscopic guidance. Residual pain was evaluated with a visual analogue scale score immediately after vertebroplasty and 1, 15, 30, 90, 180 and 270 days later. Spine and chest radiographs were obtained 24 h after vertebroplasty; spine radiography was repeated 30 days later.

Results

Therapeutic success was obtained in 88% of osteoporotic patients and in 84% of neoplastic patients. Pulmonary cement emboli were identified in four patients, all of whom were asymptomatic.

Conclusions

Percutaneous vertebroplasty is a safe and effective technique for the treatment of osteoporotic and neoplastic vertebral fractures. Clinical and imaging followup allows effective patient monitoring and early detection of possible complications.

Riassunto

Obiettivo

Questo lavoro presenta l’esperienza maturata presso il nostro Istituto di Radiologia nel trattamento dei crolli vertebrali mediante vertebroplastica percutanea. Si propone l’adozione di un follow-up clinico e radiologico volto all’individuazione delle complicanze precoci (in particolare gli emboli polmonari di cemento osseo) e tardive.

Materiali e metodi

In base alle linee guida sono stati selezionati 101 pazienti (in totale 173 vertebre): 64 osteoporotici e 37 neoplastici. Le procedure si sono svolte con la doppia guida TC e radioscopica. Follow-up clinico: mediante scala VAS si è indagato il dolore percepito dai pazienti immediatamente dopo la procedura e dopo 1, 15, 30, 90, 180 e 270 giorni. Follow-up strumentale: si sono effettuati radiogrammi del segmento di rachide trattato e del torace a 24 h dall’intervento, ripetendo quello del rachide a 30 giorni.

Risultati

Il successo terapeutico è stato raggiunto nell’88% dei pazienti osteoporotici e nell’84% di quelli neoplastici. In quattro pazienti sono stati individuati emboli polmonari di cemento osseo, asintomatici in tutti i casi.

Conclusioni

La vertebroplastica percutanea è una procedura poco invasiva e di provata efficacia nella terapia antalgica dei crolli vertebrali su base osteoporotica o neoplastica. Il follow-up clinico-strumentale consente di monitorare efficacemente i pazienti individuando precocemente le eventuali complicanze.

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Authors and Affiliations

  1. Dipartimento Discipline Medico-Chirurgiche, Sezione di Radiodiagnostica, Cattedra di Radiologia, Università degli Studi di Torino, Via Genova 3, 10026, Torino, Italy

    S. Barbero, I. Casorzo, M. Durando, G. Mattone, C. Tappero, C. Venturi & G. Gandini

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  1. S. Barbero
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  2. I. Casorzo
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  3. M. Durando
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  4. G. Mattone
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  5. C. Tappero
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  6. C. Venturi
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  7. G. Gandini
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Corresponding author

Correspondence to G. Mattone.

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Barbero, S., Casorzo, I., Durando, M. et al. Percutaneous vertebroplasty: the follow-up. Radiol med 113, 101–113 (2008). https://doi.org/10.1007/s11547-008-0234-0

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  • DOI: https://doi.org/10.1007/s11547-008-0234-0

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