Percutaneous Vertebroplasty for Severe Osteoporotic Vertebral Body Compression Fractures

Peh, Wilfred C.G.; Gilula, Louis A.; Peck, Dallas

doi:10.1148/radiol.2231010234

Cited by 243 publications

(141 citation statements)

References 12 publications

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“…However, as it proved successful with these lesions, the indications also expanded to include osteoporotic compression fractures refractory to medical treatment. The initial experience with vertebroplasty for the treatment of osteoporotic fractures has shown 70-95% pain relief [3, 13,15,18,22,23,26,28,29,31,33,46,50,51,61]. The mechanism by which PVP achieves its palliative effect is not known.…”

Section: Introductionmentioning

confidence: 99%

Vertebroplasty for osteoporotic spine fracture: prevention and treatment

2005

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IntroductionOsteoporosis is a disorder of decreased bone mass, microstructural collapse, and fragility fractures. It can affect people of all ethnic backgrounds and can result in challenging complications, ranging from compression fractures of vertebral bodies to femoral neck fractures [59]. The geriatric population is especially at risk for such osteoporotic fractures, as bone mass decreases with age [53]. A loss of one standard deviation of bone mass doubles the risk of spine fractures [34,56,59]. It is estimated that 90% of hip and spine fractures occurring in the elderly are attributable to osteoporosis [45]. The consequences of such osteoporotic vertebral fractures are diverse and include back pain, functional limitations and impairment of mood [11,37,58].A recent study in Canada examined the health-related quality of life (HRQL) in women aged 50 years and older with osteoporosis [1]. Subjects who had experienced a vertebral fracture had lower HRQL scores than participants without fracture in total score, symptoms, physical function, activities of daily living, and leisure. Acute complications of osteoporotic vertebral fractures include transient ileus, urinary retention, nausea, abdominal pain and chest pain [41,49]. Long-term effects of osteoporotic fracAbstract There is a relatively high prevalence of osteoporotic vertebral compression fractures (VCFs) in the elderly population, especially in women aged 50 or older. The result of these VCFs is increased morbidity and mortality in the short and long term. Medical treatment of these fractures includes bed rest, orthotics, analgesic medication and time. Percutaneous vertebroplasty (PVP) consists of percutaneous injection of biomaterial, such as methylmethacrylate, into the VCF to produce stability and pain relief. Biomechanical testing has shown that PVP can restore strength and stiffness of the vertebral body to the pre-fracture levels. Clinical results show immediate and maintained pain relief in 70-95% of the patients. Possible major complications include cement leakage into the spinal canal or into the venous system. Additionally, percutaneous vertebroplasty may alter the normal loading behavior of the adjacent vertebral body, and there is an increased risk of adjacent segment VCF. Kyphoplasty is a new technique, which introduces a balloon into the vertebral body transpedicularly to reduce the VCF while creating a cavity for the cement injection. This technique has the benefit of kyphosis reduction as well as less cement leakage. Research continues into the development of injectable biomaterials that are resorbable and allow for new bone formation. Vertebroplasty and kyphoplasty are safe and effective in the treatment of osteoporotic VCFs. They may allow for a faster return to function, and thus avoid the morbidity associated with medical treatment.

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Section: Introductionmentioning

confidence: 99%

Vertebroplasty for osteoporotic spine fracture: prevention and treatment

2005

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“…[1][2][3][4][5][6][7][8][9][10] Specific clinical and imaging selection criteria include duration and pattern of subjective pain; imaging characteristics on plain film, MR imaging, and CT; and findings on physical examination. Among these selection criteria, duration of pain has garnered substantial interest.…”

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confidence: 99%

The Association between the Duration of Preoperative Pain and Pain Improvement in Vertebral Augmentation: A Meta-Analysis

Rad

Luetmer

Murad³

et al. 2011

AJNR Am J Neuroradiol

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“…Although many large prospective studies demonstrating the efficacy of vertebroplasty in the treatment of benign vertebral compression fractures have been published, 1,4,5,[7][8][9][10][11][12][13][14][15][16] the data supporting its use in the treatment of compression fractures in patients with multiple myeloma remain limited. Several small studies and case series have demonstrated a beneficial effect, 1,2,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] but the largest sample size is composed of only 18 patients.…”

mentioning

confidence: 99%

Vertebroplasty in Multiple Myeloma: Outcomes in a Large Patient Series

McDonald¹,

Trout²,

Gray³

et al. 2008

AJNR Am J Neuroradiol

126

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BACKGROUND AND PURPOSE:Despite the literature supporting the efficacy of vertebroplasty for treatment of osteoporotic vertebral compression fractures, few reports exist documenting its use in the treatment of compression fractures in multiple myeloma patients. Accordingly, we sought to characterize the imaging characteristics, clinical course, and outcomes in myeloma patients treated with vertebroplasty.

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Percutaneous Vertebroplasty for Severe Osteoporotic Vertebral Body Compression Fractures

Abstract: Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures is safe and effective and should not be withheld in this group of patients.

Cited by 243 publications

References 12 publications

Vertebroplasty for osteoporotic spine fracture: prevention and treatment

Vertebroplasty for osteoporotic spine fracture: prevention and treatment

The Association between the Duration of Preoperative Pain and Pain Improvement in Vertebral Augmentation: A Meta-Analysis

Vertebroplasty in Multiple Myeloma: Outcomes in a Large Patient Series

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