Percutaneous Vertebroplasty in Osteoporotic Patients: An Institutional Experience of 1,634 Patients with Long-Term Follow-Up

Abstract

Purpose To assess long-term clinical outcome of percutaneous vertebroplasty (PV). Materials and Methods PV was performed in 1,634 patients (1,387 women; median age 73 years ± 9.3) with painful osteoporotic vertebral compression fractures (VCFs). All patients had back pain that persisted for ≥ 2 months with a concordant magnetic resonance imaging study. After PV, medical therapy for osteoporosis was continued, and patients were prospectively evaluated (follow-up 11.8–44.9 months, mean 25.0 months). Visual analog scale (VAS), Oswestry Disability Index (ODI), analgesic drug use, and use of external brace support were recorded at baseline and during follow-up. New occurrences of symptomatic vertebral fractures were recorded. Results The mean VAS score of 7.94 significantly improved to 1.12 at the primary endpoint ( P < .001). Differences in patterns of analgesic usage compared with baseline values were highly statistically significant (marginal homogeneity test, P < .001). Median ODI values of 82% before treatment significantly decreased to 6% ( P < .001). Before intervention, 1,279 patients wore a brace; 1,167 (91.2%) patients did not wear a brace after PV (χ 2 = 31.005, P < .0001). A new painful fracture with a significant higher proportion of contiguous vertebrae (63.6%) occurred in 214 (13.1%) patients ( z = 7.59, P = .025). Conclusions PV can provide durable pain relief and improvement in ambulation in patients with VCFs.