Treatment of chronic symptomatic vertebral compression fractures with percutaneous vertebroplasty

AJR Am J Roentgenol. 2004 Feb;182(2):319-22. doi: 10.2214/ajr.182.2.1820319.

Abstract

Objective: Most fractures treated with percutaneous vertebroplasty are subacute and less than 1 year old. We report our experience treating chronic vertebral fractures with vertebroplasty.

Materials and methods: Our database identified 41 patients with symptomatic fractures more than 1 year old. These patients were categorized into subgroups determined by fracture age: 12 months 1 day-24 months (n = 16) or more than 24 months 1 day (n = 25). Changes in pain and mobility for the study group were compared with those in 49 patients with fractures less than 1 year old.

Results: Thirty-three (80%) of the 41 patients in the study group had improvement in pain-seven (17%) had complete and 26 (63%) had partial relief. Forty-five (92%) of the 49 control group patients had improvement in pain-24 (49%) had complete and 21 (43%) had partial relief. The number of patients achieving partial or complete relief of pain was not statistically different between groups (p > 0.05), although complete relief was significantly more frequent in the control group (p = 0.002). Twenty patients (49%) in the study group versus 34 patients (69%) in the control group had improved mobility after vertebroplasty (p = 0.047). Patients with fractures 12 months 1 day-24 months old had improvement in mobility similar to that in patients in the control group (p = 0.962). Fractures more than 24 months 1 day old were associated with significantly less improvement in mobility (p = 0.006).

Conclusion: Most patients with fractures more than 1 year old will experience clinical benefit from vertebroplasty. Complete relief of pain is more likely when less mature fractures are treated.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Back Pain / etiology
  • Back Pain / therapy*
  • Bone Cements / therapeutic use*
  • Chronic Disease
  • Cohort Studies
  • Female
  • Humans
  • Injections, Spinal
  • Lumbar Vertebrae / injuries*
  • Male
  • Methylmethacrylate / administration & dosage*
  • Middle Aged
  • Recovery of Function
  • Retrospective Studies
  • Spinal Fractures / complications
  • Spinal Fractures / therapy*
  • Thoracic Vertebrae / injuries*
  • Time Factors
  • Treatment Outcome

Substances

  • Bone Cements
  • Methylmethacrylate