Skeletal Radiology

, Volume 40, Issue 12, pp 1531–1536 | Cite as

Treatment of severe vertebral body compression fractures with percutaneous vertebroplasty

  • Casey Young
  • Peter L. MunkEmail author
  • Manraj K. Heran
  • Michael D. Lane
  • Huy B. Q. Le
  • Steven Lee
  • M. Badii
  • Paul W. Clarkson
  • Ouellette C. Hugue
Scientific Article



Evaluate the efficacy of percutaneous vertebroplasty for severe vertebral body compression fractures.


Over a period of 6 years and 8 months, 661 vertebroplasties were performed in 292 patients at our institution. Of these, 69 patients met our criteria for a severe vertebral body compression fracture defined as vertebral body collapse to less than one-third of the original height. Of the 69, 25 underwent single level vertebroplasty. Imaging features were then analyzed including location, extent of collapse, pattern of compression, pre- and post-kyphotic angle and adjacent disc height. Complications and clinical outcomes were then evaluated.


Involved vertebra ranged from T6 to L5 with 60% at the thoracolumbar junction. Vertebral body collapse ranged from 30 to 14% (mean 22%) of original height. Pattern of collapse included 11/ 25 (44%) plana, 8/25 (32%) gibbus, and 6/25 (24%) H-shaped. Kyphotic angle before vertebroplasty ranged from 33–0° (mean 16°) with an average correction of 1.2° after vertebroplasty. Mean disc height before vertebroplasty was 7.3 mm above and 7.7 mm below. Complications included cement leak to the adjacent disc in 16 (64%) and the paravertebral soft tissues in 3 (12%). Cement leak into the proximal azygous vein was documented in one case. International Quality of Life Questionnaire VAS was completed before and after (6 weeks) the procedure by all but six patients. Mean pre-intervention VAS was reported as 7.00 (range 5–10, SD 1.73) and mean post-intervention VAS was reported as 5.11 (range 0–9, SD 2.56), demonstrating a statistically significant improvement in pain (P < 0.015, 95% CI = 0.83–2.96) with 84% or 16/19 patients reporting some degree of improvement.


Percutaneous vertebroplasty is safe and effective in the treatment of single level severe vertebral body compression fractures.


Vertebroplasty Severe vertebral compression fractures Vertebra plana Pain relief 


Conflict of interest

The authors declare that there is no conflict of interest.


  1. 1.
    Layton KF, Thielen KR, Kock CA, Luetmer PH, Lane JI, Wald JT, et al. Vertebroplasty, first 1000 levels of a single center: evaluation of the outcomes and complications. Am J Neuroradiol. 2007;28:683–9.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Diel P, Merky D, Roder C, Popp A, Perler M, Heini PF. Safety and efficacy of vertebroplasty: early results of a prospective one-year case series of osteoporosis patients in an academic high-volume center. Indian J Orthop. 2009;43:228–33.CrossRefGoogle Scholar
  3. 3.
    Fenoglio L, Cena P, Migliore E, et al. Vertebroplasty in the treatment of osteoporosis vertebral fractures: report on 52 cases. J Endocrinol Investig. 2008;31:795–8.CrossRefGoogle Scholar
  4. 4.
    McCall T, Cole C, Dailey A. Vertebroplasty and kyphoplasty: a comparative review of efficacy and adverse events. Curr Rev Musculoskeletal Med. 2008;1:17–23.CrossRefGoogle Scholar
  5. 5.
    Diamond TH, Bryant C, Browne L, Clark WA. Clinical outcomes after acute osteoporotic vertebral fractures: a 2-year non-randomized trial comparing percutaneous vertebroplasty with conservative therapy. Med J Aust. 2006;184:113–7.Google Scholar
  6. 6.
    Kumar K, Verma AK, Wilson J, LaFontaine A. Vertebroplasty in osteoporotic spine fractures: a quality of life assessment. Can J Neurol Sci. 2005;32:487–95.CrossRefGoogle Scholar
  7. 7.
    Trout AT, Kallmes DF, Gray LA, Goodnature BA, Everson SL, Comstock BA, et al. Evaluation of vertebroplasty with a validated outcome measure: the Roland-Morris Disability Questionnaire. Am J Neuroradiol. 2005;26:2652–7.Google Scholar
  8. 8.
    Evans AJ, Jensen ME, Kip KE, DeNardo AJ, Lawler GJ, Negin GA, et al. Vertebral compression fractures: pain reduction and improvement in functional mobility after percutaneous polymethylmethacrylate vertebroplasty retrospective report of 245 cases. Radiology. 2003;226:366–72.CrossRefGoogle Scholar
  9. 9.
    Heffernan EJ, O’Sullivan PJ, Alkubaidan FO, Heran MK, Legiehn GM, Munk PL. The current status of percutaneous vertebroplasty in Canada. Can Assoc Radiol J. 2008;59:77–82.Google Scholar
  10. 10.
    Peh WC, Gilula LA, Peck DD. Percutaneous vertebroplasty for severe osteoperotic vertebral body compression fractures. Radiology. 2002;223:121–6.CrossRefGoogle Scholar
  11. 11.
    O’Brien JP, Sims JT, Evans AJ. Vertebroplasty in patients with severe vertebral compression fractures: a technical report. Am J Neuroradiol. 2000;21:1555–8.Google Scholar
  12. 12.
    Shimony JS, Gilula LA, Zeller AJ, Brown DB. Percutaneous vertebroplasty for malignant compression fractures with epidural involvement. Radiology. 2005;232:846–53.CrossRefGoogle Scholar
  13. 13.
    Hentschel SJ, Rhines LD, Shah HN, Burton AW, Mendel E. Percutaneous vertebroplasty in vertebra plana secondary to metastasis. J Spinal Disord Tech. 2004;17:554–7.CrossRefGoogle Scholar
  14. 14.
    Klazen CA et al. VERTOS II: percutaneous vertebroplasty versus conservative therapy in patients with painful osteoporotic vertebral compression fractures; rationale, objectives and design of a multicenter randomized controlled trial. Trials 8:33CrossRefGoogle Scholar
  15. 15.
    Buchbinder R, Osbrone RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med. 2009;361:557–68.CrossRefGoogle Scholar
  16. 16.
    Kallmes DF, Comstock BA, Heagerty PJ, et al. A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med. 2009;361:569–79.CrossRefGoogle Scholar
  17. 17.
    Hirsch JA, Reddy AS, Linfante I, Rachlin JR. Pseudo-Kummel’s disease: a unique application for verebroplasty. Pain Physician. 2003;6:207–11.Google Scholar
  18. 18.
    Cotton A, Boutry N, Cortet B, et al. Percutaneous vertebroplasty: state of the art. Radiographics. 1998;18:311–20.CrossRefGoogle Scholar
  19. 19.
    Deramond H, Derpriester C, Galibert P, Le Gars D. Percutaneous vertebroplasty with polymethylmethacrylate: technique, indications, and results. Radiol Clin North Am. 1998;36:533–46.CrossRefGoogle Scholar
  20. 20.
    Hodler J, Peck D, Gilula LA. Midterm outcome after vertebroplasty: predictive value of technical and patient-related factors. Radiology. 2003;227:662–8.CrossRefGoogle Scholar
  21. 21.
    Moreland DB, Landi MK, Grand W. Vertebroplasty: techniques to avoid complications. Spine J. 2001;1:66–71.CrossRefGoogle Scholar
  22. 22.
    Rousing R, Hansen KL, Andersen MO, Jespersen SM, Thomsen K, Lauritsen JM. Twelve-months follow-up in forty-nine patients with acute/semiacute osteoporotic vertebral fractures treated conservatively or with percutaneous vertebroplasty: a clinical randomized study. Spine. 2010;35:478–82.CrossRefGoogle Scholar
  23. 23.
    Becker S, Meissner J, Tuschel A, Chavanne A, Ogon M. Cement leakage into the posterior spinal canal during ballon kyphoplasty: a case report. J Orthop Surg. 2007;15:222–5.CrossRefGoogle Scholar

Copyright information

© ISS 2011

Authors and Affiliations

  • Casey Young
    • 1
  • Peter L. Munk
    • 1
    Email author
  • Manraj K. Heran
    • 1
  • Michael D. Lane
    • 1
  • Huy B. Q. Le
    • 1
  • Steven Lee
    • 1
  • M. Badii
    • 2
  • Paul W. Clarkson
    • 3
    • 4
  • Ouellette C. Hugue
    • 1
    • 5
  1. 1.Vancouver General HospitalUniversity of British ColumbiaVancouverCanada
  2. 2.Department of Internal Medicine, Division of Rheumatology, Vancouver General HospitalUniversity of British ColumbiaVancouverCanada
  3. 3.Department of OrthopedicsUniversity of British ColumbiaVancouverCanada
  4. 4.British Columbia Cancer AgencyVancouverCanada
  5. 5.Harvard UniversityCambridgeUSA

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