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Interventional Radiology
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my personal edition > interventional radiology > news
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DGDispatch
Largest Case Series of Vertebroplasty Shows Procedure Reduces Pain With Good Safety Profile: Presented at SIR
By Ed Susman
WASHINGTON, DC -- March 19, 2008 -- In the largest long-term case series of patients undergoing percutaneous vertebroplasty, researchers found the procedure to be safe while resulting in major improvements in patients' well being.
Percutaneous vertebroplasty is performed using imaging guidance to inject medical-grade bone cement into the spine to stabilise collapsed vertebra. The procedure is designed to reduce pain and may prevent further collapse of the vertebra.
In a press briefing here at the Society of Interventional Radiology (SIR) 33rd Annual Scientific Meeting, Giovanni Anselmetti, MD, Head of Interventional Radiology, Institute for Cancer Research and Treatment, Candiolo, Turin, Italy, discussed the results of a study that evaluated the efficacy and safety of the procedure in the treatment of patients with osteoporosis-associated vertebral fractures.
Dr. Anselmetti and colleagues asked 884 patients to evaluate their vertebral fracture pain before and after undergoing vertebroplasty using a visual analog scale ranging from 0 (no pain) to 10 (the most excruciating pain ever experienced). Patients were also surveyed on their quality of life before and after the procedure. During the 52-month follow-up period, they were also asked to contact the researchers if they experienced new back pain.
Patients were also followed using magnetic resonance imaging (MRI) and radiographic studies.
Prior to the operation 69.3% of the patients reported poor quality of life, whereas after the operation 18.8% of patients indicated poor quality of life (P < .001), he said.
Imaging studies revealed new vertebral fractures in 12% of patients; 69% of the fractures occurred adjacent to the bone that had been fractured and had repaired.
About 95.6% of the patients treated for osteoporosis-associated vertebral fractures reported that their pain was reduced by vertebroplasty, Dr. Anselmetti said.
Mean pain level on the visual analog scale decreased from 7.9 at baseline to 1.3 after the procedure (P < .0001).
"A total of 845 patients out of 884 in this study obtained relief from vertebroplasty," he said in his press briefing. Dr. Anselmetti will deliver the paper March 19.
The fracture complication rate of 13.7% compares favourably with other studies in which placebo fracture complications occurred in 18.9% of patients and fracture complications occurred in 10% to 12% of patients treated medically, he noted.
Dr. Joshua Hirsch, MD, Director of Interventional Neuropathology, Massachusetts General Hospital, Boston, Massachusetts, said the case series is the largest prospective study of the procedure.
"The question of whether repair of one vertebra with cement causes fracture in the adjacent vertebrae remains a hot issue," said Dr. Hirsch, who moderated the press briefing. He also said the question of whether prophylactic vertebroplasty should be performed on adjacent vertebrae is still controversial.
[Presentation title: Percutaneous Vertebroplasty in the Osteoporosis Patients: 5 Years Prospective Follow-Up in 884 Consecutive Patients. Abstract 182]
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