Vertebroplasty Relieves Pain and Provides Sustained Benefit

The results of a five-year follow-up study show that vertebroplasty for osteoporotic spinal fracture provides dramatic pain relief and greatly decreases disability.

Researchers at the Institute for Cancer Research and Treatment (IRCC, Turin, Italy) conducted a prospective follow-up of 884 osteoporosis patients who underwent vertebroplasty. The researchers measured average pre-treatment pain score on the 11-point Visual Analog Scale (VSA), and measured patients ability to manage daily tasks--such as washing, dressing, or standing--by using the Oswestry Disability Questionnaire (ODQ), which was completed by patients both before and one month after vertebroplasty. Patients were also followed using magnetic resonance imaging (MRI) and radiographic studies.

The results showed that while the average pre-treatment VSA pain score was 7.9 (+/- 1.5), it dropped significantly to an average of 1.3 (+/- 1.8) after the vertebroplasty treatment; the ODQ scores changed from an average of 69.3% (+/- 13.5%) to 18.8% (+/- 6.9%), showing a highly significant improvement in mobility. The study also showed that vertebroplasty does not increase the risk of fracture in the level contiguous to previously treated vertebra, and that these new fractures occur at the same rate as they would in osteoporosis patients who did not have vertebroplasty. The study results were presented at the Society of Interventional Radiology's 33rd Annual Scientific Meeting, held during March 2008 in Washington (D.C., USA).

"These data provide good news for physicians and osteoporosis patients. Many osteoporosis patients with compression fractures are in terrible pain and have a greatly diminished ability to perform basic daily activities, such as dressing themselves,” said study presenter Giovanni Anselmetti, M.D., head of interventional radiology at the IRCC. "Osteoporosis patients who have persistent spinal pain lasting more than three months should consult an interventional radiologist, and those who require constant narcotic pain relief should seek help immediately.”

Vertebroplasty, the injection of medical-grade bone cement into a fractured vertebra, is an outpatient procedure performed under conscious sedation. A needle is inserted through a nick in the skin in the back, and is directed under fluoroscopy--continuous, moving X-ray imaging--into the fractured vertebra. The physician then injects the bone cement into the vertebra; the cement hardens within about 15 minutes and stabilizes the fracture. Vertebroplasty is indicated for painful vertebral compression fractures that fail to respond to conventional medical therapy, such as minimal or no pain relief with analgesics or narcotic doses that are intolerable.


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