OUTCOMES OF VERTEBROPLASTY FOR TREATMENT OF PATHOLOGIC VERTEBRAL FRACTURES AND HAEMANGIOMAS

Abstract

Objective. To compare the intensity of pain-relieving effect of percutaneous vertebroplasty (PV) in patients with gemangiomas, osteoporotic vertebral fractures, and malignant metastases. Matherial and Methods. 210 percutaneous vertebroplasties (VP) were performed in 121 patients at the age of 18 to 87 years. Out of them 22 patients had metastases into vertebral body/bodies, 72 patients – osteoporotic fractures, and 27 patients – vertebral haemangiomas with high-grade pain syndrome. The levels of vertebroplasty were between T3 and S1, predominantly (178 cases) from T9 to L4 levels. Significant anatomic abnormalities in seven cases required CT-guidance of the percutaneous vertebroplasty. Pain syndrome intensity before and after PV was assessed by visualanalogue scale. Results. Percutaneous vertebroplasty resulted in significant pain relief in all patients. One hundred-and-one patients reported full satisfaction with treatment, 17 patients – partial satisfaction, and 3 patients were not satisfied. Vertebroplasty complicated by cement leakage into the spinal canal in two patients with multiple myeloma. One patient with osteoporotic fractures has developed L5 radiculopathy after four-level PV, which was eliminated in 5 days. Three patients had transient complications. Conclusion. The achieved results confirm a high painrelieving efficacy of percutaneous vertebroplasty. A choice of vertebroplasy technique depends on a nature of pathology and peculiarities of vertebral anatomy. Application of cement based on calcium phosphate, bioceramic and bone morphogenetic proteins improves the long-term outcomes of percutaneous vertebroplasty.