ABSTRACT

Object:

Vertebroplasty was first applied by Harve Deramond to a patient with vertebral hemangioma in 1984. In recent years, the increase in the number of osteoporosis, trauma and tumor cases has increased the incidence of vertebral compression fractures (VCFs). Nowadays, percutaneous vertebroplasty (PVP) has been a widely used treatment for painful acute VCFs. It is a minimally invasive technique. In this procedure, polymethylmethacrylate (PMMA) is injected into the vertebral corpus. There are PMMA’s ability to increase stability at fracture site, thermal necrosis effect and chemotoxic effect on intra-osseous pain receptors. In this study, the safety and efficacy of PVP in patients with VCF were evaluated.

Methods:

The patients who underwent PVP under sedoanalgesia or general anesthesia for single or multi-level thoracolumbar vertebrae fracture were reviewed retrospectively between January 2012 and December 2018. The study included 111 patients with VCF. 140 vertebral levels were treated with PVP. These VCFs were evaluated in 3 groups as osteoporotic, traumatic and pathological. We used the Oswestry Disability Index (ODI) for functional disability and the Visual Analog Scale (VAS) for pain severity. Our patients were followed up for 12 month after PVP.

Results:

Patients mean age was 73,04 ± 7,17 years (91-56 years) and 18 (16,22 %) were male and 93 (83,78 %) were female. The most commonly affected vertebrae were T12 and L1 vertebrae corpus. Following PVP, VAS and ODI values decreased significantly in the last 12 months compared to preoperative levels (p<.001). Cement leakage was occurred in six patients (5.40 %).

Conclusions:

PVP is an advantageous method. Because the procedure is fast and easy, a biopsy can be taken during the procedure, patients can soon stand up and be discharged; its complications are much less than open surgery. In addition to general anesthesia, it can be performed with sedoanalgesia. It is a reliable and effective technique for the treatment of pain due to osteoporotic and traumatic VCFs or metastatic lesions.