Radiological findings as favorable predictors of pain relief in patients with osteoporotic compression fractures after percutaneous vertebroplasty: a retrospective study of 156 cases
- First Online:
We evaluated the relationships between pre-procedural radiological findings and short-term pain relief in patients with osteoporotic compression fractures after percutaneous vertebroplasty (PVP).
Materials and methods
A retrospective review of pre-procedural radiological images of 156 patients with painful osteoporotic compression fracture was performed. Pain was measured with a visual analogue scale (VAS). Complete pain relief was defined as a VAS pain score of 0 or 1 at 3 months after PVP. Statistical analyses were conducted to evaluate the relationship between the pre-procedural imaging factors and pain relief using Pearson’s chi-squared test. Multivariate logistic regression analysis was also performed.
Complete pain relief was obtained in 45.5% of patients. An intravertebral cleft larger than half the height of the fractured vertebral body (FVB) was a significant key factor in the complete pain relief group after 3 months. Further, ≥40% of the spinal canal occupied by bony fragments of the FVB was related to incomplete pain relief.
A large intravertebral cleft was a favorable short-term outcome predictor in patients with osteoporotic compression fractures after PVP, while severe protrusion of the FVB causing lumbar spinal canal stenosis was not a favorable short-term outcome predictor of complete pain relief.
KeywordsPVP Outcome predictor Intravertebral cleft Pain relief
- 2.Martin JB, Jean B, Sugiu K, San Millan Ruiz D, Piotin M, Murphy K, Rufenacht B, Muster M, Rufenacht DA. Vertebroplasty: clinical experience and follow-up results. Bone. 1999;25:11S–5S.Google Scholar
- 6.Evans AJ, Jensen ME, Kip KE, DeNardo AJ, Lawler GJ, Negin GA, Remley KB, Boutin SM, Dunnagan SA. Vertebral compression fractures: pain reduction and improvement in functional mobility after percutaneous polymethylmethacrylate vertebroplasty retrospective report of 245 cases. Radiology. 2003;226:366–72.PubMedCrossRefGoogle Scholar
- 17.O’Brien J, Brennan D, Taylor D, O’Byrne J, Eustace S. Percutaneous vertebroplasty—initial clinical experience in osteoporotic and myelomatous compression fractures. J Med Sci. 2006;175:50–3.Google Scholar
- 20.Kim YJ, Lee JW, Kim KJ, Chung SK, Kim HJ, Park JM, Kang HS. Percutaneous vertebroplasty for intravertebral cleft: analysis of therapeutic effects and outcome predictors. Skeletal Radiol. 2010 (Epub ahead of print).Google Scholar
- 23.Kamano H, Hiwatashi A, Kobayashi N, Fuwa S, Takahashi O, Yoshiura T, Saida Y, Honda H, Numaguchi Y. New vertebral compression fractures following prophylactic vertebroplasty in osteoporotic patients. Presented at annual meeting of 48th ASNR, May 15–20, 2010.Google Scholar
- 26.Kallmes DF, Comstock BA, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH, Edwards R, Gray LA, Stout L, Owen S, Hollingworth W, Ghdoke B, Annesley-Williams DJ, Ralston SH, Jarvik JG. A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med. 2009;361(6):569–79.PubMedCrossRefGoogle Scholar
- 28.Klazen CA, Lohle PN, de Vries J, Jansen FH, Tielbeek AV, Blonk MC, Venmans A, van Rooij WJ, Schoemaker MC, Juttmann JR, Lo TH, Verhaar HJ, van der Graaf Y, van Everdingen KJ, Muller AF, Elgersma OE, Halkema DR, Fransen H, Janssens X, Buskens E, Mali WP. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet. 2010 (Epub ahead of print).Google Scholar
- 34.Hoshino M, Nakamura H, Terai H, Tsujio T, Nabeta M, Namikawa T, Matsumura A, Suzuki A, Takayama K, Takaoka K. Factors affecting neurological deficits and intractable back pain in patients with insufficient bone union following osteoporotic vertebral fracture. Eur Spine J. 2009;18:1279–86.PubMedCrossRefGoogle Scholar