Abstract
Purpose: Osteoporotic vertebral fractures with no sign of vertebral collapse on initial radiographs, which is so-called occult vertebral fractures (VFs), exist. Occult VFs have a high rate of missed diagnosis, and the treatment of these fractures has rarely been discussed in the literature. We evaluated the effects of vertebral bone drilling for the pain due to occults VFs. Materials and Methods: Eighteen patients with painful osteoporotic occult VFs underwent the vertebral bone drilling. We evaluated the clinical outcome by comparing numerical rating scale (NRS) and activity of daily life (ADL) values between before and after the vertebral bone drilling. Comparisons were made by using Wilcoxon signed rank test. Results: The mean baseline NRS and ADL score, and the mean NRS and ALD score after the bone drilling were 8.4 ± 0.8, 2.2 ± 0.6, 2.4 ± 1.0, 4.6 ± 0.5, respectively. Among the patients, we detected significant improvements in NRS pain score and ADL score after the drilling compared with baseline score (p < 0.0002). Conclusion: Vertebral bone drilling at the site of painful vertebral compression fractures alleviated the intractable pain due to osteoporotic occult VFs.
Highlights
Osteoporotic vertebral fractures (VFs) with no sign of vertebral collapse do exist about 20% [1]
Patient Factors A total of 18 patients with 28 osteoporotic occult VFs were enrolled in this study
There were significant improvements in average numerical rating scale (NRS) score during 24 hours compared with baseline (p < 0.0002)
Summary
Osteoporotic vertebral fractures (VFs) with no sign of vertebral collapse do exist about 20% [1]. The evaluation of the osteoporotic occult VFs is difficult due to the unapparent radiographic findings [2]. How to cite this paper: Ota, K. and Nagai, H. (2016) Vertebral Bone Drilling (Puncture) Attenuates the Intractable Pain Due to Vertebral Fractures without Collapse. Nagai imaging (MRI) is an important diagnosis tool for the osteoporotic VFs without collapse. The typical MRI findings in acute compression fracture are hypointensity T1-weighted images, hyperintensity or heterogeneous intensity on T2-weighted images, and hyperintensity on fat-suppressed T2-weighted images [3]
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