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Injection With Cement Compound Reduces Pain, Improves Function in Patients With Vertebral Compression Fractures
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Posted on: 05/31/2007
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Vertebral compression fractures, or VTF, are fairly common among older people and they can be very painful, leading to difficulty moving around. People who have VTF can see a significant decline in their health and it can lead to death. VTF are most often caused by osteoporosis, thinning of the bones, or some sort of trauma. The usual way of treating VTF is through conventional treatments such as bed rest, pain medications, bisphosphonates (medications that strengthen the bone), or back bracing. However, for many people, this doesn't provide enough relief or slow down the progression.
This nonrandomized study investigated the outcomes of 21 patients with painful VTF that hadn't responded to conservative treatment. The investigators wanted to compare the outcomes of patients who underwent vertebroplasty (PV) with those who had balloon kyphoplasty (KP). Both procedures strengthen the bone through an injection of a cement compound into the area that has fractured. KP is a technique that resulted from modifying PV. With KP, a balloon is inserted within the collapsed area before the cement compound is injected. The advantage is the lower incidence of leakage.
All patients in the study, men and women, had fractures for six months or fewer. Their level of pain was measured by Visual Analog Scale before the procedure at one and 48 hours after the procedure, and again at one, three, and six months after. Functional improvement was measured by Oswestry Disability Index (ODI) before the procedure and six months after. The authors also looked for complications.
After analyzing the patients' results, the researchers found that the pain scores before the procedures significantly dropped after the procedures. Before, all patients reported an average score of 8.6 out of 10 for pain. After the procedure, the pain scores were down to an average of 0.55 in the KP group and 0.70 in the PV group. Results were similar in functional improvement. Before the procedure, the PV group had an average of 74 percent disability and the KP group, 77 percent. After the procedure, the PV group had an average of 24 percent disability and the KP group, 23 percent.
Leakage of the cement compound happened five times in patients who underwent PV, but no symptoms resulted. There were no neurological problems reported in any patient in either group.
The authors concluded that although the reason for the pain relief from these procedures isn't clearly understood yet, they are effective treatments for patients with VTF. The significantly reduce the level of pain and improve the functional ability. The researchers point out that the procedures should be done early in the course of the disease before too much structural damage has occurred.
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References:
Pasquale De Neri, MD, et al. Treatment of Painful Osteoporotic or Traumatic Vertebral Compression Fractures by Percutaneous Vertebral Augmentation Procedures. In Clin J Pain. June 2007. Vol. 23. No. 5.
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