Treatment of uncomplicated vertebral compression fractures

Abstract

To compare the outcomes of surgical (vertebroplasty) and conservative treatment in management of pain syndrome in patients with uncomplicated spine injury. The study involved 60 patients with stable uncomplicated compression fractures of vertebral bodies in the thoracic and lumbosacral spine. These patients were subdivided into two groups. Group 1 consisted of 30 patients who had undergone unilateral transpedicular percutaneous vertebroplasty; Group 2 involved 30 patients who had undergone a course of conservative treatment. The medical records and the catamnestic follow-up data of patients treated at the Neurosurgery Department of the Research Clinical Center of JSC Russian Railways in 2015-2017 were analyzed for this purpose. No statistically significant differences in sex, age, and level of injury were revealed between the study groups. A comparative analysis of treatment outcomes demonstrated that pain intensity assessed using the VAS scale was significantly reduced after one-year follow-up in both groups as compared to the baseline. A statistically significant decrease in pain intensity in the group of patients who had undergone vertebroplasty was observed as early as one month after the injury. No significant intergroup differences were observed in the long-term follow-up period (3 and 6 months) for this parameter. In five out of 60 patients, examination 12 months after the injury revealed that vertebral body height decreased by up to 10%. No statistically significant correlation with the treatment method was observed. Vertebroplasty provides a statistically better pain relief during the first month after spine injury as compared to conservative treatment. For patients, this means earlier activization and quicker return to daily routines and work.