Percutaneous transpedicular polymethyl methacrylate vertebroplasty for thetreatment of spinal compression fractures

OBJECTIVE: To assess the safety, feasibility, and clinical outcome of percu taneous transpedicular polymethylmethacrylate vertebroplasty (PTPV) for the treatment of spinal compression fractures causing refractory pain. METHODS: We retrospectively reviewed a consecutive group of patients underg oing PTPV at our institution between April 1998 and January 2001. Outcome m easures included analgesic requirements, ambulatory status, sleep comfort, and overall quality of life 2 weeks after the procedure. RESULTS: A total of 97 patients (73 women and 24 men) underwent 258 PTPV pr ocedures during 133 treatment sessions. The mean age was 76 years (range, 4 2-99 yr). The mean duration of follow-up was 14.7 months (range, 2-35 mo). Most of the patients had osteoporotic compression fractures, although some had osteolytic malignancies. Complete follow-up was obtained in 81 patients (84%). Narcotic and analgesic usage decreased in 63% of patients, increase d in 7%, and remained the same in 30%. Ambulation and mobility were improve d in 51%, worse in 1% and the same in 48%. One-half of the patients were ab le to sleep more comfortably after the procedure, whereas the other half re mained the same. Most patients who reported no change in sleep or ambulatio n had experienced no impairment of these activities before PTPV. Overall, 7 4% of patients believed that PTPV significantly enhanced their quality of l ife and 26% reported no change. No patient was worse after PTPV. One patien t with preexisting pneumonia died of respiratory failure after the procedur e; another died of an acute stroke weeks later. One patient developed sympt omatic pulmonary embolism of cement, and another developed transient quadri ceps weakness from radiculopathy. Other complications were minor and infreq uent. There were no infections. CONCLUSION: PTPV provided significant relief in a high percentage of patien ts with refractory pain. PTPV is a safe and feasible treatment for patients with spinal compression fractures.