Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures: a preliminary report.

BACKGROUND: This report assesses the efficacy and safety of percutaneous vertebroplasty for osteoporotic vertebral compression fractures and reports on preliminary results of its use. METHODS: The technique was used on 50 patients with 86 painful vertebral fractures, all of which had failed to respond to earlier conservative medical treatment. The technique involves percutaneous puncture of the involved vertebra via a transpedical approach followed by injection of polymethyl methacrylate (PMMA) into the compressed vertebra. Patients were asked to quantity their degree of pain on Huskisson's visual analogue scale (VAS) to assess the clinical symptoms and surgical results. RESULTS: The procedures were technically successful in all patients, and no complications relating to either the anesthesia or the surgical procedure were reported. The quantity of PMMA injected per vertebral body varied from 2.5 to 12 ml according to both the position of the damaged vertebra(e) and the severity of the compression fracture. Pain, as assessed on the Huskisson's VAS, decreased from 82 +/- 15 mm at the baseline to 37 +/- 22 mm on the first postoperative day, and 32 +/- 19 mm at 1 month. Reductions in pain from the baseline to the first day and to 1 month were both statistically significant (p <0.05). All patients were able to return to their previous activity and quality of life. CONCLUSION: Through the expertise and attention of experienced surgeons, percutaneous vertebroplasty appears to provide a very good surgical choice for patients with vertebral compression fractures, as this surgical procedure is able to eliminate the risk of major spinal surgery, and through prompt pain relief, may provide early mobilization and rehabilitation for elderly polymorbid patients.