Functional Outcomes and New Vertebral Fractures in Percutaneous Vertebroplasty and Conservative Treatment of Acute Symptomatic Osteoporotic Vertebral Compression Fractures

Abstract

The present study compared the clinical functional outcomes and new vertebral compression fractures (NVCFs) between percutaneous vertebroplasty (PVP) and conservative treatment (CT) in patients with severe pain due to acute osteoporotic vertebral compression fractures (OVCFs). PVP has been increasingly used for the treatment of pain in patients with OVCFs. However, the effectiveness of the procedure and whether it causes NVCFs has remained controversial. A total of 544 eligible patients with OVCFs found on spinal radiographs and intractable back pain for ≤6 weeks were recruited from September 2012 to February 2018 and assigned to PVP (n= 280; 392 levels) or CT (n= 264; 366 levels). The visual analog scale and Oswestry Disability Index scores were determined before the intervention and at the 1-week and 1-, 3-, 6-, 12-, and 24-month follow-up examinations. In addition, monthly telephone follow-up interviews were performed. In the case of a sudden increase in back pain, the patient returned to the hospital for medical and magnetic resonance imaging examinations for NVCF detection. The PVP group had significantly lower visual analog scale and Oswestry Disability Index scores than those for the CT group at 1 week and 1, 3, and 6 months (P < 0.05). However, the differences after 6 months were not statistically significant (P > 0.05). Similar numbers of NVCFs (total and adjacent fractures) were found at 24 months in both groups (P > 0.05). Compared with CT, PVP provided a rapid decrease in pain and an early return to daily life activities, without an increase in the incidence of NVCFs.