Vertebroplasty Shows Promise for Vertebral Compression Fracture Treatment

Vertebroplasty, an interventional radiology treatment for vertebral compression fractures, provides patients with significant pain relief and lasting benefit, according to a 5-year follow-up study of 884 osteoporosis patients.

The procedure calls for the injection of medical-grade bone cement into a fractured vertebra, and acts like an internal cast on the fracture. It is particularly effective for painful vertebral compression fractures that do not respond to analgesics or intolerable narcotics. The average pre-treatment pain score on the 11-point Visual Analog Scale was 7.9 +/- 1.5, and it dropped significantly to an average of 1.3 +/- 1.8 after the vertebroplasty treatment.

The Oswestry Disability Questionnaire (ODQ), which measures a patient’s ability to manage everyday life, was completed by patients before, and one month after vertebroplasty, and showed greatly improved mobility—from an average of 69.3 percent +/- 13.5 to 18.8 percent +/- 6.9.

"These data provide good news for physicians and osteoporosis patients. Many osteoporosis patients with compression fractures are in terrible pain and have a greatly diminished ability to perform basic daily activities, such as dressing themselves," said Giovanni C. Anselmetti, M.D., interventional radiologist at the Institute for Cancer Research and Treatment in Turin, Italy. While vertebroplasty can improve a patient’s quality of life, the procedure is generally reserved for people for whom conventional medical management was ineffective.

"Osteoporosis patients who have persistent spinal pain lasting more than three months should consult an interventional radiologist, and those who require constant narcotic pain relief should seek help immediately," noted Anselmetti. The treatment was completed in all patients without major complications and with good clinical results. The data add to the body of evidence in the United States for the minimally invasive treatment’s safety, effectiveness and low-complication rate. The treatment is widely available in the United States at all major institutions and many smaller institutions and is generally covered by health insurance.

The study also showed that vertebroplasty does not increase the risk of fracture in nearby vertebra. "Vertebroplasty is already known to be a safe and effective treatment for osteoporotic vertebral fractures. Osteoporosis patients remain susceptible to new fractures, which often occur in the contiguous vertebra to an existing fracture. Our large-scale study shows that vertebroplasty does not increase the risk of fracture in the level contiguous to previously treated vertebra and that these new fractures occur at the same rate as they would in osteoporosis patients who did not have vertebroplasty," added Anselmetti.

The research was presented at the Society of Interventional Radiology’s 33rd Annual Scientific Meeting.

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