J Korean Neurosurg Soc.  2009 Jan;45(1):16-23. 10.3340/jkns.2009.45.1.16.

The Prognostic Factors Influencing on the Therapeutic Effect of Percutaneous Vertebroplasty in Treating Osteoporotic Vertebral Compression Fractures

• Ryu KS
• Park CK

• KMID: 1466338
• DOI: http://doi.org/10.3340/jkns.2009.45.1.16

Abstract

OBJECTIVE
This retrospective study of 215 patients with 383 symptomatic osteoporotic vertebral compression fractures (VCFs) treated by percutaneous vertebroplasty (PVP), was performed to evaluate the clinical outcomes, and to analyze the various clinical factors affecting these results.
METHODS
The authors assessed the clinical outcome under the criteria such as the pain improvement, activity, requirement of analgesics, and the patient's satisfaction, and determined the relation to various peri- and intra-operative factors, and postoperative imaging findings.
RESULTS
The outcome was determined as 84.2% in relief of pain, 72.0% in change in activity, 65.7% in analgesics use, and 84.7% of satisfaction rate. More severe focal back pain, high uptake bone scan, and the lower mean T-score were related to the better pain relief following PVP. The longer the duration between fracture and PVP, the less severe focal back pain, low uptake bone scan, and leakage of PMMA into the paravertebral space were related to the less improvement in activity. Female and low uptake bone scan showed a correlation with more analgesic use. The longer the duration between fracture and PVP, low uptake bone scan, and the higher the mean T-score were correlated with the less the patients satisfaction.
CONCLUSION
Our study suggests that PVP may be more effective in the acute phase of VCFs, more severe focal pain, and far advanced osteoporosis on BMD. Leakage of PMMA into the paravertebral spcae also could be affecting the surgical results.

Keyword

Osteoporosis; Vertebral compression fracture; Vertebroplasty

MeSH Terms

Analgesics
Back Pain
Female
Fractures, Compression
Humans
Low Back Pain
Osteoporosis
Polymethyl Methacrylate
Retrospective Studies
Vertebroplasty
Analgesics
Polymethyl Methacrylate