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Vertebroplasty: what is important and what is not
AJNR. American Journal of Neuroradiology
|August 29, 2009
Summary
Vertebroplasty did not increase adjacent vertebral compression fractures within one year. Cement volume and extravasation did not predict fractures or improve pain relief in patients with osteoporotic fractures.
Area of Science:
- Orthopedic surgery
- Interventional radiology
- Biomaterials science
Background:
- Osteoporotic vertebral compression fractures (VCFs) are a significant cause of morbidity.
- Vertebroplasty is a minimally invasive procedure to treat VCFs.
- Uncertainty exists regarding optimal vertebroplasty techniques and outcomes.
Purpose of the Study:
- To evaluate if vertebroplasty increases adjacent VCF risk within one year.
- To assess the correlation between cement volume and pain relief.
- To determine the consequences of cement extravasation.
Main Methods:
- Prospective study of 357 patients (660 vertebrae) with osteoporotic VCFs.
- Pain relief and adjacent VCF incidence were monitored for one year.
- Statistical analysis included Pearson correlation and multiple logistic regression.
Main Results:
- 12% of patients experienced adjacent VCFs within one year.
- Cement volume and intravertebral disk extravasation did not predict adjacent VCFs.
- No correlation was found between cement volume and pain relief (r = -0.029).
- 33% of VCFs showed cement extravasation (veins, soft tissue, disk) without complications.
Conclusions:
- The incidence of adjacent VCFs after vertebroplasty is similar to untreated VCFs.
- Cement volume and intravertebral disk extravasation do not influence adjacent VCF risk.
- Cement volume is not correlated with pain relief in patients undergoing vertebroplasty.
