Vertebroplasty For Osteoporotic Vertebral Compression Fractures Research Articles

Clinico-Radiological Outcome of Percutaneous Vertebroplasty in Dorso-Lumbar Osteoporotic Vertebral Compression Fractures (OVCFs)

Introduction: Vertebral compression fractures (VCFs) are the most common complication of osteoporosis where Percutaneous vertebroplasty is thought to immediately improve the pain and disability status via stabilization and reinforcement of the fractured body with polymethylmethacrylate (PMMA) injection. Purpose: To evaluate the clinical and radiological outcome of Percutaneous vertebroplasty in osteoporotic VCFs in Dorso-Lumbar (DL) Spine. Materials and methods: It is a prospective study carried out in Bangabandhu Sheikh Mujib Medical University (BSMMU) and different private hospitals in Dhaka, from January 2010 to March 2023. Total number of patients was 121 i.e., 92 female 29 male patients (167 treated vertebrae), age ranged from 65-85 years with mean age 73.40 years. 10 cases at D10 and D11 each, 26 cases at D12, 21 cases at L1, 15 cases at L2, 16 cases at D12-L1, 03 case at D9,12, 05 cases at D10,11, 07 cases at L1,2 and 03 case at D9,12L1 and 05 cases at D12,L1,2. Follow up ranged from 24 to 36 months and outcome assessed regarding neurological status (Radiculopathy and Myelopathy), pain [Visual Analogue Score (VAS)] and disability [Oswestry Disability Index (ODI) questionnaire]. Radiological assessment of the treated spine was done to identify any vertebral height gain (McKiernan method), kyphosis correction (Cobb`s method). Results: The mean age was 73.40 ± 03.75 years. 74(60.97%) patients were in 65-74 years age group. 105(63.41%) cases had single vertebral level, 49(29.26%) with 02 levels and 12(07.32%) with 03 levels involvement. D12 (n=53, 31.17%) and L1 (n=52, 31.13%) were most frequent. The age, sex, occupation, and the level of involvement had no significant difference (p>0.05, chi-squared test). VAS for pain had significantly improvement (p<0.05, paired t test) from preoperative 08.50±0.50 to 03.50±0.30 postoperatively and 02.80± 0.50 at 1 year. The preoperative ODI 71.11±09.69 improved significantly (p<0.05, paired t test) to 17.34±04.11 postoperatively and 09.76± 04.83% at 1 year. The kyphotic angle was corrected to 05°±02.50° at the 12 months follow up radiograph. One level (02.30%) had cement leakage which was evident on postoperative X-ray but was asymptomatic even on the last follow up. Conclusion: Percutaneous Vertebroplasty is a significantly effective technique for immediate and short-term pain relief, disability status improvement in Vertebral Compression Fractures (VCFs) with satisfactory radiological outcome in DL spine.

Translated article] Sagittal imbalance influences outcome of vertebroplasty in patients with osteoporotic vertebral compression fracture

Background and objectivesThe correlation between sagittal balance of the spine and clinical outcome after vertebroplasty (VP) in patients with osteoporotic vertebral compression fractures (OVCF) is poorly investigated. We analysed the clinical outcome of patients with OVCF undergoing VP taking into account sagittal balance. MethodsThe primary endpoint was the change in axial back pain; disability and health-related quality of life using VAS, ODI and SF-36 respectively in correlation to the parameters that define sagittal balance (SVA). Radiographic assessment included full spine standing lateral films. Imaging and clinical data were collected pre and post procedure at 1, 3 and 12 months. ResultsFifty-one patients were included presenting a total of 113 OVCF. Thirty patients (60.7%) had multiple OVCF. Comparing the evolution of VAS and ODI throughout the follow-up it does not seem that there are significant differences in their behaviour between the SVA>50mm and the SVA<50mm groups (p>0.05). On the contrary, preVP SF-36 scores showed worst results in the SVA>50mm group in the physical functioning section (PF) (p<0.05) and in the physical component score (PCS) (p<0.05). These differences were maintained until 3 months of follow-up in the case of the PCS and until the end of follow-up in the case of the PF (p<0.05). ConclusionsPatients with a SVA>50mm showed a slower recovery of their quality of life after VP for OVCF, but without significant differences with respect to pain or disability, when compared with patients with SVA<50mm.

Influencia del desequilibrio sagital en el resultado clínico de la vertebroplastia en pacientes con fractura por compresión vertebral osteoporótica

Background and objectivesThe correlation between sagittal balance of the spine and clinical outcome after vertebroplasty (VP) in patients with osteoporotic vertebral compression fractures (OVCF) is poorly investigated. We analysed the clinical outcome of patients with OVCF undergoing VP taking into account sagittal balance. Material and methodThe primary endpoint was the change in axial back pain, disability and health-related quality-of-life using Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and SF-36, respectively, in correlation to the parameters that define sagittal balance (SVA). Radiographic assessment included full spine standing lateral films. Imaging and clinical data were collected pre- and post-procedure at 1, 3 and 12 months. Results51 patients were included presenting a total of 113 OVCF. 30 patients (60.7%) had multiple OVCF. Comparing the evolution of VAS and ODI throughout the follow-up it does not seem that there are significant differences in their behaviour between the SVA>50mm and the SVA<50mm groups (p>0.05). On the contrary, pre-VP SF-36 scores showed worst results in the SVA>50mm group in the physical functioning (PF) section (p<0.05) and in the physical component score (PCS) (p<0.05). These differences were maintained until 3 months of follow-up in the case of the PCS and until the end of follow-up in the case of the PF (p<0.05). ConclusionsPatients with a SVA>50mm showed a slower recovery of their quality-of-life after VP for OVCF, but without significant differences with respect to pain or disability, when compared patients with SVA<50mm.