Percutaneous vertebroplasty for osteoporotic compression fractures: long-term evaluation of the technical and clinical outcomes

The purpose of this article is to evaluate the technical and clinical outcomes of 194 patients with 500 osteoporotic vertebral compression fractures (VCFs) consecutively treated by percutaneous vertebroplasty, to investigate the long-term efficacy of percutaneous vertebroplasty, and to determine the frequency of new VCFs after percutaneous vertebroplasty.

One hundred ninety-four patients (168 women and 26 men; mean age, 73.3 years; range, 44-89 years) with 500 VCFs (T5-L5) were enrolled in this study. Evaluation at each follow-up time point (1 day, 1 month, 4 months, 1 year, and then once yearly) included pain response by using a pain visual analog scale (VAS) and frontal and lateral radiographs of the thoracic and lumbar vertebrae regardless of the symptoms.

The mean volume of cement injected was 3.3 mL (range, 0.5-12 mL) per level. Cement leakage was seen at 213 levels (42.6%). The mean follow-up time was 31 months (range, 1-97 months). The mean VAS score was 7.6 before percutaneous vertebroplasty and 3.1 at 1 day, 2.3 at 1 month, 1.7 at 4 months, 1.5 at 1 year, 1.2 at 2 years, 1.0 at 3 years, 1.1 at 4 years, 0.9 at 5 years, 0.9 at 6 years, and 1.0 at 7 years after percutaneous vertebroplasty. New VCFs were confirmed in 103 vertebrae in 65 patients (33.5%), affecting 65 adjacent vertebrae (63.1%) and 38 nonadjacent vertebrae (36.9%).

Percutaneous vertebroplasty was effective in relieving the pain associated with osteoporosis-induced VCFs, and the analgesic effect was long lasting when no new VCF occurred. However, radiologic follow-up observation showed that new VCFs occurred in approximately one-third of the patients.