Percutaneous vertebroplasty in the treatment of thoracolumbar fractures

Abstract

Objective The objective was to determine the effect of percutaneous vertebroplasty (PV) through cement injection in relief of pain in case of painful osteoporotic and pathological thoracolumbar fractures. Background Vertebroplasty is a percutaneous polymethylmethacrylate cement injection inside the vertebral body through the pedicle and used mainly in the treatment of painful osteoporotic and pathological spinal fractures. Patients and methods A total of 20 patients in this study had thoracolumbar fractures (15 of them had osteoporotic fractures and five of them had pathological fractures). Patients were submitted into one of the three age groups. Group 1: less than 60 years, group 2: between 60 and 70 years, and group 3: above 70 years. Results The analgesic effect of PV was evaluated using visual analogue scale and activities of daily living immediately after operation and the patients were followed for 6 months radiologically and clinically using these scales. All of them were improved and four of them had cement leakage with no neurological insult. One of them had leakage with neurological insult which is improved by overnight injection of methylprednisolone. Conclusion PV has become common in many practices worldwide. It has been used by surgeons as a good therapy for the treatment of painful osteoporotic and pathological compression fractures of the spine which do not respond to medical treatment of osteoporosis. Nowadays, it has been the best option of treatment for these compression fractures in the world. PV is a simple operation and can be done in an outpatient clinic. Pain relief has been high and risks low, when done by experienced surgeons who exercise good judgment.