Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: An open prospective study

Objective. To assess the efficacy and safety of percutaneous vertebroplasty in osteoporotic vertebral compression fractures responsible for severe and persistent pain. Methods. Sixteen patients were included in this open prospective study. Inc lusion criteria were: one or 2 vertebral fractures responsible for severe p ain, i.e., higher than 50 mm on a visual analog scale (VAS: 0-100 mm), scor es 3, 3 or 5 according to the McGill-Melzack scoring system, and evolving f or more than 3 months. Assessment criteria were the changes over time (Days 3, 30, 90, 180) in VAS and McGill-Melzack, scoring system. The changes ove r time in a generic health status instrument score [the Nottingham Health P rofile (NHP)] were also assessed. Statistical comparisons were performed us ing the Wilcoxon T test. Results. There were 9 women and 7 men: postmenopausal osteoporosis (n = 7), corticosteroid induced osteoporosis (n = 2), and male osteoporosis (n = 7) . Vertebroplasty was performed in 20 vertebrae. A statistically significant decrease of both VAS (-53%, p < 0.0005) and McGill-Melzack scoring system (p < 0.005) was observed at Day 3. The results were also significant at Day s 30, 90, and 180 fur both scales (p < 0.005 and p < 0.01, respectively). A significant decrease over time for 5/6 dimensions of the NHP score was als o noted: pain (p < 0.01), physical mobility (p < 0.05), emotional reactions (p < 0.05), social isolation (p < 0.05), and energy (p < 0.05). We observe d no adverse event, and no vertebral fracture has occurred after 6 months o f followup. Conclusion. Percutaneous vertebroplasty is a useful and safe procedure for treating persistent painful osteoporotic fractures. Controlled studies with long-term followup are required.