Percutaneous Vertebroplasty in the Treatment of Senile Osteoporotic Vertebral Body Compression Fractures: Treatment Efficacy and Complications

Kang, Dong Ho; Kim, Ki Jeong; Lee, Chul Hee; Hwang, Soo Hyun; Kim, Eun Sang; Jung, Jin Myung

Abstract

BACKGROUNDS: The purpose of this study is to clarify therapeutic efficacy of percutaneous vertebroplasty(PVP) using polymethylmethacrylate(PMMA) for the osteoporotic compression fractures of the spine and to define the complications following the procedures.
METHODS
The authors retrospectively analyzed the clinical outcome of 51 consecutive patients with recent osteoporotic compression fractures undergone PVP between January, 2000 and December, 2001. We reviewed medical records, radiographic findings, and telephone questionaires. The clinical outcomes were categorized by visual analogue scale(VAS).
RESULTS
The mean age of the patients was 70.2 years old(range, 60~84) and the male/female ratio was 9:42(17.6%:82.4%). Mean duration of symptom was 2.75 months(0.25~12). Mean follow up periods were 12.2 months(5~27). Among the 63 treated segments, most of them were thoracolumbar junction(69.8%, 44/63) and treated via bipedicular route(bipedicular/unipedicular: 47/16). Thirty-eight patients showed complete or partial relief of pain(82.6%). Age, sex, duration of symptom, number of involved segments, and approach(uni-/bipedicular) had no statistical significance to clinical outcome. Nonetheless leakage of acrylic cement was noted in 37 patients(72.5%), most of them were asymptomatic. The complications were 4 symptomatic leakages(4 transient radicular pain), 1 pulmonary embolisms, and 1 fractured acrylic cement.
CONCLUSION
PVP using PMMA is a minimally invasive, safe and effective treatment modality providing primary stability and prompt pain relief for the osteoporotic vertebral compression fractures. As most of the complications are related with leakage of acrylic cement, preoperative CT scan, vertebral phlebography and fluoroscopic guidance are mandatory as well as cautious injection of adequate amount of PMMA.