Percutaneous Polymethylmethacrylate Vertebroplasty In the Treatment of Osteoporotic Thoracic and Lumbar Vertebral Compression Fractures: Early Outcome of 159 Patients

Chun–Kun Park, MD, PhD
Jae–Eon Lee
Kyung–Suck Cho
Younk–Geun Choi
Sunk Chan Park
Joon–Ki Kang (Seoul Korea)

Increasing numbers of elderly persons are sustaining vertebral compression fractures (VCF) due to osteopenia. Recently, percutaneous vertebroplasty (PCVP) with polymethylmethacrylate (PMMA) has been introduced. The authors tried to prospectively elucidate the effects of this method on the clinical outcome in osteoporotic VCF. Between April 24, 1998 and July 30,1999, 349 PCCV were performed by a single operator in 159 patients, who had single or multiple VCF that were confirmed by bone scan. Patients included 21 men and 138 women aged 41–90 years. The mean t–score of bone density was –3.424. The decrease in vertebral body height was more than 50% in 84.8% of the levels. The pain scoring system was VAS score (0–10). The preoperative VAS score ranged 6.63–10 (mean 7.04). 135 patients were followed up (mean: 3.2 months). The mean amount of PMMA injected was 4.6cc in each level. Postoperatively mean VAS score decreased to 4.93 within 48 hours (n=l59) and 1.74 during follow–up (n=l35). Increase of compressed body height was observed in 38 patients, but not directly related to pain relief. 20 patients presented transient new symptoms such as buttock pain and needed symptomatic treatments. Leaks of PMMA were detected by CT in 60 levels, which appeared to increase immediate VAS score, but did not exert influence on the late outcome.

Our results demonstrate that improvement of pain with early ambulation can be obtained in osteoporotic VCF treated with PMMA vertebroplasty. Prognostic factors of PCVP will be discussed.