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Vertebroplasty versus Active Control Intervention for Chronic Osteoporotic Vertebral Compression Fractures: The
Dennis Carli1, Alexander Venmans1, Paul Lodder1
1From the Departments of Radiology (D.C., A.V., T.v.O., I.B., K.S., A.S., C.S., P. Lohle), Internal Medicine (E.D.), and Medical Psychology (J.d.V.), ETZ Hospital (Elisabeth Tweesteden Ziekenhuis), Hilvarenbeekseweg 60, 5022GC, Tilburg, the Netherlands; Department of Medical and Clinical Psychology, Tilburg University, Warandelaan2, 5037AB, Tilburg, the Netherlands (P. Lodder, J.d.V.); and Department of Radiology, Massachusetts General Hospital, Boston, Mass (J.H.).
Percutaneous vertebroplasty (PV) offers superior pain relief and quality of life improvements for chronic painful osteoporotic vertebral compression fractures (OVCFs) compared to anesthetic injections alone. Disability outcomes were similar between the groups after 12 months.
Area of Science:
- Orthopedics
- Interventional Radiology
- Pain Management
Background:
- Limited evidence exists for percutaneous vertebroplasty (PV) in treating chronic painful osteoporotic vertebral compression fractures (OVCFs).
- Chronic OVCFs significantly impact patient quality of life and daily functioning.
Purpose of the Study:
- To compare the efficacy of PV versus an active control (anesthetic infiltration) in managing pain, improving quality of life, and reducing disability in patients with chronic OVCFs.
Main Methods:
- A prospective randomized clinical trial involving 80 participants with chronic OVCFs and bone marrow edema on MRI.
- Participants were randomized to PV (n=40) or active control (n=40).
- Primary outcome was pain severity (Visual Analog Scale - VAS) over 12 months; secondary outcomes included Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) and Roland Morris Disability Questionnaire (RMDQ) scores.
Main Results:
- At 12 months, the PV group showed significantly greater improvement in VAS scores (P=.02) and QUALEFFO scores (P=.02) compared to the active control group.
- The difference in RMDQ scores between groups was not statistically significant (P=.18).
- Both groups experienced baseline pain scores around 7.6, with PV group showing a greater reduction at 12 months.
Conclusions:
- Percutaneous vertebroplasty is more effective than anesthetic injection alone for pain relief and enhancing quality of life in chronic OVCFs.
- PV and anesthetic injection provide similar improvements in disability for patients with chronic OVCFs.
- Further research may explore long-term functional outcomes and cost-effectiveness.
