Skip to main content
Log in

Chronic obstructive pulmonary disease (COPD) patients with osteoporotic vertebral compression fractures (OVCFs): improvement of pulmonary function after percutaneous vertebroplasty (VTP)

  • Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To investigate the changes of respiratory function in patients affected by chronic obstructive pulmonary disease (COPD) with single dorsal osteoporotic vertebral compression fractures (OVCFs) treated with vertebroplasty (VTP).

Methods

Forty-five patients affected by COPD and single dorsal OVCF underwent VTP (29 men, 16 women; mean age 71.4 years, range 65–77 years). Inclusion criteria were magnetic resonance findings of bone marrow oedema, without intracanal bone fragments and refractory pain to medical treatment for at least 3 months. Osteoporosis was assessed by bone densitometry. Spirometry was performed before and after treatment.

Results

A significant VAS-score decrease was observed 1 week after VTP, with a subsequent decrease over time; vital capacity (VC) and forced vital capacity (FVC) improved over time, reaching a plateau at 3 months. Forced expiratory volume at 1 s (FEV1) did not significantly differ between the pre-VTP values and follow-up values. A significant correlation was observed between VAS-score values and VC, and VAS-score values and FVC. No significant correlation was observed between VAS-score values and FEV1 values.

Conclusions

VTP improves restrictive ventilatory impairment in patients with moderate and severe COPD affected by single thoracic OVCFs. We recommend this treatment in the management of these patients.

Key Points

Osteoporosis is a major comorbidity in chronic obstructive pulmonary disease (COPD) patients.

Pain due to osteoporotic vertebral compression fractures worsens respiratory failure in COPD.

Vertebroplasty improves ventilatory impairment in COPD patients with osteoporotic vertebral compression fractures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Abbreviations

COPD:

Chronic obstructive pulmonary disease

OVCFs:

Osteoporotic vertebral compression fractures

VTP:

Vertebroplasty

PMMA:

Polymethylmethacrylate

References

  1. Barth RW, Lane JM (1988) Osteoporosis. Orthop Clin North Am 19:845–858

    CAS  PubMed  Google Scholar 

  2. Lane NE (2006) Epidemiology, etiology, and diagnosis of osteoporosis. Am J Obstet Gynecol 194:S3–S11

    Article  CAS  PubMed  Google Scholar 

  3. Wu SS, Lachmann E, Nagler W (2003) Current medical, rehabilitation, and surgical management of vertebral compression fractures. J Womens Health 12:17–26

    Article  Google Scholar 

  4. Tanigawa N, Kariya S, Kojima H et al (2008) Improvement in respiratory function by percutaneous vertebroplasty. Acta Radiol 49:638–643

    Article  CAS  PubMed  Google Scholar 

  5. Dong R, Chen L, Gu Y et al (2009) Improvement in respiratory function after vertebroplasty and kyphoplasty. Int Orthop 33:1689–1694

    Article  PubMed Central  PubMed  Google Scholar 

  6. Silva DR, Coelho AC, Dumke A et al (2011) Osteoporosis prevalence and associated factors in patients with COPD: a cross-sectional study. Respir Care 56:961–968

    Article  PubMed  Google Scholar 

  7. Graat-Verboom L, Smeenk FW, van den Borne BE et al (2012) Risk factors for osteoporosis in Caucasian patients with moderate chronic obstructive pulmonary disease: a case control study. Bone 50:1234–1239

    Article  PubMed  Google Scholar 

  8. Tantucci C (2012) COPD and osteoporosis: something more than a comorbidity. Endocrine 42:5–6

    Article  CAS  PubMed  Google Scholar 

  9. Eckel TS, Olan W (2009) Vertebroplasty and vertebral augmentation techniques. Tech Vasc Interv Radiol 12:44–50

    Article  PubMed  Google Scholar 

  10. Hurley MC, Kaakaji R, Dabus G et al (2009) Percutaneous vertebroplasty. Neurosurg Clin N Am 20:341–359

    Article  PubMed  Google Scholar 

  11. Galibert P, Deramond H, Rosat P, Le Gars D (1987) Preliminary note on the treatment of vertebral angioma percutaneous acrylic vertebroplasty. Neurochirugie 33:166–168, Article in French

    CAS  Google Scholar 

  12. Garfin SR, Yuan HA, Reiley MA (2001) New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine 26:1511–1515

    Article  CAS  PubMed  Google Scholar 

  13. Anselmetti GC, Marcia S, Saba L et al (2012) Percutaneous vertebroplasty: multi-centric results from EVEREST experience in large cohort of patients. Eur J Radiol 81:4083–4086

    Article  PubMed  Google Scholar 

  14. Wong CC, McGirt MJ (2013) Vertebral compression fractures: a review of current management and multimodal therapy. J Multidiscip Healthc 6:205–214

    PubMed Central  PubMed  Google Scholar 

  15. Hsieh MK, Chen LH, Chen WJ (2013) Current concepts of percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures: evidence-based review. Biomed J 36:154–161

    Article  PubMed  Google Scholar 

  16. Chandra RV, Yoo AJ, Hirsch JA (2013) Vertebral augmentation: update on safety, efficacy, cost effectiveness and increased survival? Pain Physician 16:309–320

    PubMed  Google Scholar 

  17. Chitale A, Prasad S (2013) An evidence-based analysis of vertebroplasty and kyphoplasty. J Neurosurg Sci 57:129–137

    CAS  PubMed  Google Scholar 

  18. Voormolen MH, Mali WP, Lohle PN et al (2007) Percutaneous vertebroplasty compared with optimal pain medication treatment: short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures. The VERTOS study. AJNR Am J Neuroradiol 28:555–560

    CAS  PubMed  Google Scholar 

  19. Klazen CA, Lohle PN, de Vries J et al (2010) Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet 376:1085–1092

    Article  PubMed  Google Scholar 

  20. Masala S, Calabria E, Nano G et al (2013) Traumatic burst fracture with spinal channel involvement augmentation with bioactive strontium-hydroxyapatite cement. Case Rep Orthop 2013:613149

    CAS  PubMed Central  PubMed  Google Scholar 

  21. Mathis JM (2003) Percutaneous vertebroplasty: complication avoidance and technique optimization. AJNR Am J Neuroradiol 24:1697–1706

    PubMed  Google Scholar 

  22. Carlin BW (2012) COPD and associated comorbidities: a review of current diagnosis and treatment. Postgrad Med 124:225–240

    Article  PubMed  Google Scholar 

  23. Tanigawa N, Kariya S, Komemushi A, Nakatani M, Yagi R, Sawada S (2012) Added value of percutaneous vertebroplasty: effects on respiratory function. AJR Am J Roentgenol 198:W51–W54

    Article  PubMed  Google Scholar 

  24. Yang HL, Zhao L, Liu J et al (2007) Changes of pulmonary function for patients with osteoporotic vertebral compression fractures after kyphoplasty. J Spinal Disord Tech 20:221–225

    Article  CAS  PubMed  Google Scholar 

  25. Klazen CA, Verhaar HJ, Lampmann LE et al (2007) 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 8:33

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Farrokhi MR, Alibai E, Maghami Z (2011) Randomized controlled trial of percutaneous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures. J Neurosurg Spine 14:561–569

    PubMed  Google Scholar 

  27. Rousing R, Hansen KL, Andersen MO, Jespersen SM, Thomsen K, Lauritsen JM (2010) 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 (Phila Pa 1976) 35:478–482

    Article  Google Scholar 

  28. Cimen OB, Ulubaş B, Sahin G, Calikoğlu M, Bağiş S, Erdoğan C (2003) Pulmonary function tests, respiratory muscle strength, and endurance of patients with osteoporosis. South Med J 96:423–426

    Article  PubMed  Google Scholar 

  29. Ettinger B, Black DM, Nevitt MC et al (1992) Contribution of vertebral deformities to chronic back pain and disability. J Bone Miner Res 7:449

    Article  CAS  PubMed  Google Scholar 

  30. Ryan PJ, Blake G, Herd R, Fogelman I (1994) A clinical profile of back pain and disability in patients with spinal osteoporosis. Bone 15:27

    Article  CAS  PubMed  Google Scholar 

  31. Harrison RA, Siminoski K, Vethanayagam D, Majumdar SR (2007) Osteoporosis-related kyphosis and impairments in pulmonary function: a systematic review. J Bone Miner Res 22:447–457

    Article  PubMed  Google Scholar 

  32. Chen YJ, Chen HY, Tsai PP, Lo DF, Chen HT, Hsu HC (2012) Significance of dynamic mobility in restoring vertebral body height in vertebroplasty. AJNR Am J Neuroradiol 33:57–60

    Article  PubMed  Google Scholar 

  33. Kelekis A, Filippiadis DK, Vergadis C et al (2014) Comparative prospective study of load distribution projection among patients with vertebral fractures treated with percutaneous vertebroplasty and a control group of healthy volunteers. Cardiovasc Intervent Radiol 37:186–192

    Article  PubMed  Google Scholar 

  34. Frankel BM, Monroe T, Wang C (2007) Percutaneous vertebral augmentation: an elevation in adjacent-level fracture risk in kyphoplasty as compared with vertebroplasty. Spine J 7:575–582

    Article  PubMed  Google Scholar 

  35. Lin WC, Lee YC, Lee CH et al (2008) Refractures in cemented vertebrae after percutaneous vertebroplasty: a retrospective analysis. Eur Spine J 17:592–599

    Article  PubMed Central  PubMed  Google Scholar 

  36. Lieberman IH, Dudeney S, Reinhardt MK, Bell G (2001) Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine (Phila Pa 1976) 26:1631–1638

    Article  CAS  Google Scholar 

  37. Masala S, Ciarrapico AM, Konda D, Vinicola V, Mammucari M, Simonetti G (2008) Cost-effectiveness of percutaneous vertebroplasty in osteoporotic vertebral fractures. Eur Spine J 17:1242–1250

    Article  PubMed Central  PubMed  Google Scholar 

  38. Svedbom A, Alvares L, Cooper C, Marsh D, Ström O (2013) Balloon kyphoplasty compared to vertebroplasty and non-surgical management in patients hospitalised with acute osteoporotic vertebral compression fracture—a UK cost-effectiveness analysis. Osteoporos Int 24:355–367

    Article  CAS  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgements

The scientific guarantor of this publication is Professor Salvatore Masala M.D. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was not required because this study did not require off-label use of materials, methods and procedures non-standardised. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, observational, performed at one institution.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amedeo Taglieri.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Masala, S., Magrini, A., Taglieri, A. et al. Chronic obstructive pulmonary disease (COPD) patients with osteoporotic vertebral compression fractures (OVCFs): improvement of pulmonary function after percutaneous vertebroplasty (VTP). Eur Radiol 24, 1577–1585 (2014). https://doi.org/10.1007/s00330-014-3165-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-014-3165-2

Keywords

Navigation