Pain and Functional Outcomes Following Vertebroplasty for Vertebral Compression Fractures

Abstract

Introduction: There is a dearth of comparative outcome data on vertebroplasty for the treatment of vertebral compression fractures (VCF) according to vertebral level, number of levels, and etiology. The aim of this study was to investigate improvement of pain and function following vertebroplasty for a heterogenous cohort of patients with medically refractory VCF. Materials and Methods: A prospective observational study was conducted on a cohort of consecutive patients undergoing vertebroplasty following at least 4 weeks of failed medical management, between April 2007 and March 2012 at a single Neurosurgical center. Pain Visual Analogue Scale (VAS) scores, Oswestry Disability Index (ODI) scores, analgesic usage, and complications were recorded preoperatively and at 1 day, 1 week, 1 month, 6 months, and 1 year postoperatively. Intraoperative vertebral body biopsy was performed routinely. Results: 202 levels were augmented in 147 patients. The most common levels augmented were T12 (17%), L1 (18%), and L4 (10%). Significant reductions in pain VAS and ODI scores were evident at day 1 and sustained at up to 1 year postoperatively (P<0.001). They were not dependent on the level of fracture (T3-10, T11-L2, L3-S1) (P>0.05), number of levels treated (single level, 2 levels, >2 levels) (P>0.05), or etiology of VCF (P>0.05). At 1 year postoperatively, 79% (113/142) had no or reduced analgesic usage. The complication rate was 6% (9/147). There were 5 mortalities, none of which were directly related to surgery. Conclusions: Vertebroplasty for medically refractory VCF may offer sustained improvement in pain and function. The procedure is associated with low morbidity and mortality.