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Treatment of painful Modic type I changes by vertebral augmentation with bioactive resorbable bone cement

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

Low back pain is one of the most common causes of seeking medical attention in industrialized western countries. End plate degenerative changes in the acute phase, formally referred to as Modic type I, represent a specific cause. The aim of this study is to evaluate the effectiveness of vertebral augmentation with calcium sulfate and hydroxyapatite resorbable cement in patients with low back pain resistant to conservative treatment whose origin can be recognized in Modic type I changes.

Methods

From February 2009 to October 2013, 1,124 patients with low back pain without radicular symptoms underwent physical and imaging evaluation. Stringent inclusion criteria elected 218 to vertebral augmentation with resorbable cement. Follow-up period was 1 year.

Results

One hundred seventy-two (79 %) patients improved quickly during the first 4 weeks after treatment. Forty-two (19 %) patients showed a more gradual improvement over the first 6 months, and at 1 year, their pain level did not differ from that of the previous group. In both groups, pain did not resolved completely, but patients showed significant improvement in their daily life activities. Two (1 %) patients did not show any improvement. Two (1 %) patients died for other reasons. There were no complications related to the procedures.

Conclusion

Vertebroplasty with bioactive resorbable bone cement seems to be an effective therapeutic option for patients with low back pain resistant to conservative treatment whose origin could be recognized in Modic type I end plate degenerative changes.

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Ethical standards and patient consent

We declare that all human and animal studies have been approved by our institution’s ethical committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, “Fondazione PTV”—Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy

    Salvatore Masala, Giovanni Nano, Amedeo Taglieri, Eros Calabria, Marcello Chiocchi & Giovanni Simonetti

  2. Interventional Radiology Unit, Institute for Cancer Research and Treatment, Candiolo, Italy

    Giovanni Carlo Anselmetti

  3. Radiology Unit, ASL8 Cagliari - SS, Trinità Hospital, Cagliari, Italy

    Stefano Marcia

Authors
  1. Salvatore Masala
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  2. Giovanni Carlo Anselmetti
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  3. Stefano Marcia
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  4. Giovanni Nano
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  5. Amedeo Taglieri
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  6. Eros Calabria
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  7. Marcello Chiocchi
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  8. Giovanni Simonetti
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Correspondence to Amedeo Taglieri.

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Masala, S., Anselmetti, G.C., Marcia, S. et al. Treatment of painful Modic type I changes by vertebral augmentation with bioactive resorbable bone cement. Neuroradiology 56, 637–645 (2014). https://doi.org/10.1007/s00234-014-1372-9

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  • DOI: https://doi.org/10.1007/s00234-014-1372-9

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