Treatment of pain from osteoporotic vertebral collapse by percutaneous PMMA vertebroplasty.

[Guest guest]

Treatment of pain from osteoporotic vertebral collapse by percutaneous

PMMA vertebroplasty.

Author(s): Winking M; Stahl J; Oertel M; Schnettler R; Boker D;

Background. Vertebral compression fractures are common complications in

advanced osteoporosis. In general, this disease of the elderly patient

is characterized by severe local back pain. Pathophysiologically, bony

instability triggers local pain during body movement. Serious pain

immobilizes

the patients and forces them to bed rest. As a result, complications like

thrombosis or pneumonia occur. Invasive treatment with surgical

instrumentation

for vertebral stabilization is not indicated in elderly patients especially

with additional diseases.

The purpose of this study was to test the hypothesis

that percutaneous polymethylmethacrylate (PMMA) vertebroplasty significantly

reduces pain due to vertebral collapse in osteoporotic patients and improves

quality of life. Methods. A total of 38 patients with osteoporotic vertebral

compression fractures of the thoracic and lumbar spine were treated by

PMMA vertebroplasty. After admission, before discharge from the hospital,

six weeks, half a year and one year later patients answered the Oswestry

Low Back Pain Disability (OLBPD) Questionnaire for assessment of treatment

related change in disability. In all patients percutaneous vertebroplasty

was performed under local anesthesia.

Findings. A total of 92% of patients reported a significant pain reduction

immediately after treatment. Also one year after vertebroplasty pain

remained

significantly reduced. Vertebroplasty was highly beneficial for patients

with

pain related to local instability

of the spine. Extravasation of PMMA beyond the vertebral margins was

observed

in 26% of the cases. No treatment related clinical or neurological

complications

were noticed. Interpretation. PMMA vertebroplasty is a useful and safe

method of pain relief which rapidly regains quality of life for patients

with osteoporotic vertebral compression.

Acta neurochirurgica.; 2004 May;146(5) p469 - 476