J Korean Soc Spine Surg.  2016 Sep;23(3):139-145. 10.4184/jkss.2016.23.3.139.

Comparison of Outcomes of Conservative Treatment, Early Vertebroplasty, and Delayed Vertebroplasty in Patients with Osteoporotic Vertebral Compression Fractures

• Im SH
• Ahn YJ
• Yang BK
• Yi SR
• Lee YH
• Kwon JE
• Kim JM

• KMID: 2353903
• DOI: http://doi.org/10.4184/jkss.2016.23.3.139

Abstract

STUDY DESIGN: Retrospective study.
OBJECTIVES
To compare the treatment outcomes of conservative treatment, early vertebroplasty (EVP), and delayed VP (DVP) of patients with osteoporotic compression fractures. SUMMARY OF LITERATURE REVIEW: VP is regarded as an effective treatment for osteoporotic compression fractures. Few studies have compared the outcomes of each of the following treatments: conservative treatment, EVP, and DVP.
MATERIALS AND METHODS
A total of 202 patients who presented with thoracolumbar osteoporotic vertebral compression fractures between January 2008 and December 2013 were divided into three groups: group 1 (conservative treatment), group 2 (VP within three weeks), and group 3 (VP after three weeks). We compared the collapse rate and the visual analog scale (VAS) score immediately after the trauma and at the 1-week, 3-week, 6-week, and 1-year follow-ups.
RESULTS
The three abovementioned groups consisted of 89 patients, 60 patients, and 53 patients, respectively. The bone mass density (BMD) score of group 1 was statistically significantly higher than that of the others (p<0.05). In group 2, the average VAS score was high immediately after the trauma and low at the 1-year follow-up. Only group 2 showed a significantly high vertebral compression rate immediately after the trauma (p<0.05). Although there were no statistically significant differences in the incidence between the adjacent and the non-adjacent vertebral compression fractures, more patients underwent additional VP in groups 2 and 3 (p=0.980).
CONCLUSION
The treatment method of performing EVP seems to yield the best clinical outcomes for patients with osteoporotic compression fractures who exhibit a relatively low BMD, high collapse rate, and high VAS score. Conservative management is the treatment of choice for osteoporotic compression fracture patients with a relatively high BMD, low collapse rate, and low VAS score.

Keyword

Fractures; Compression; Osteoporosis; Vertebroplasty

MeSH Terms

Follow-Up Studies
Fractures, Compression*
Humans
Incidence
Methods
Osteoporosis
Retrospective Studies
Vertebroplasty*
Visual Analog Scale

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