| Title | Management of acute osteoporotic vertebral fractures: a nonrandomized trial comparing percutaneous vertebroplasty with conservative therapy. | | Author(s) | Diamond TH, Champion B, Clark WA | | Institution | Department of Endocrinology, Saint George Hospital Campus, University of New South Wales, Grey Street, NSW 2217, Sydney, Australia. terrydiamond@optushome.com.au | | Source | Am J Med 2003 Mar; 114(4):257-65. | | MeSH | Aged
Aged, 80 and over
Bone Cements
Bone Density
Chi-Square Distribution
Female
Follow-Up Studies
Fractures, Spontaneous
Humans
Male
Middle Aged
Orthopedic Procedures
Osteoporosis
Pain Measurement
Physical Therapy Modalities
Probability
Range of Motion, Articular
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Spinal Fractures
Statistics, Nonparametric
Treatment Outcome
| | Abstract | PURPOSE: We sought to determine whether percutaneous vertebroplasty--which involves the injection of cement to stabilize a fractured vertebral body--may be an effective treatment for vertebral fracture.
METHODS: We enrolled 79 consecutive osteoporotic patients (24 men and 55 women; ages 51 to 93 years) presenting with acute vertebral fractures. Clinical characteristics and bone densitometry were measured at baseline. Pain scores (on a 0 to 25 scale) and levels of function (on a 0 to 20 scale) were recorded on presentation, at 24 hours, at 6 weeks, and 6 to 12 months after therapy.
RESULTS: Fifty-five patients (70%) were treated by percutaneous vertebroplasty and 24 (30%) were treated by conservative therapy alone. They were followed for a mean of 215 days (range, 57 to 399 days). The baseline clinical characteristics, bone densitometry, and fracture data were similar in the two groups. Twenty-four hours after vertebroplasty, there was a 53% reduction in pain scores (from 19 to 9; P = 0.0001) and a 29% improvement in physical functioning (from 14 to 18; P = 0.0001), whereas pain scores and physical functioning remained unchanged at 24 hours in the patients treated conservatively (both P = 0.0001 compared with the changes after percutaneous vertebroplasty). Thirteen patients (24%) treated by percutaneous vertebroplasty were able to cease all analgesia after 24 hours (P = 0.0001 compared with none of the 24 patients treated conservatively). Clinical outcomes at 6 weeks and 6 to 12 months were similar in both groups.
CONCLUSION: When compared with conservative therapy, percutaneous vertebroplasty results in prompt pain relief and rapid rehabilitation. In experienced hands, it is a safe and effective procedure for treating acute osteoporotic vertebral compression fractures. | | Language | eng | | Pub Type(s) | Clinical Trial
Controlled Clinical Trial
Journal Article
| | PubMed ID | 12681451 |
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