Vertebroplasty For Osteoporotic Spinal Fractures Provides Dramatic Pain Relief, Greatly Decreases Disability
The results of a five-year follow-up study of 884 osteoporosis patients bolster the use of vertebroplasty -- an interventional radiology treatment for vertebral compression fractures -- finding that the procedure provides dramatic pain relief and sustained benefit, announced researchers at the Society of Interventional Radiology's 33rd Annual Scientific Meeting.
Vertebroplasty, the injection of medical-grade bone cement into a fractured vertebra, shores up the fracture similar to an internal cast and provides pain relief. It is indicated for painful vertebral compression fractures that fail to respond to conventional medical therapy, such as minimal or no pain relief with analgesics or narcotic doses that are intolerable. The average pre-treatment pain score on the 11-point Visual Analog Scale was 7.9 +/- 1.5, and it dropped significantly to an average of 1.3 +/- 1.8 after the vertebroplasty treatment.
One's ability to manage everyday life -- such as washing, dressing or standing--was measured by the commonly used Oswestry Disability Questionnaire (ODQ), which was completed by patients before -- and again one month after--vertebroplasty. The ODQ scores changed from an average of 69.3 percent +/- 13.5 to 18.8 percent +/- 6.9, showing a highly significant improvement in mobility.
"These data provide good news for physicians and osteoporosis patients. Many osteoporosis patients with compression fractures are in terrible pain and have a greatly diminished ability to perform basic daily activities, such as dressing themselves," said Giovanni C. Anselmetti, M.D., interventional radiologist at the Institute for Cancer Research and Treatment in Turin, Italy.
Vertebroplasty can greatly improve one's quality of life; however, the treatment is generally reserved for patients who have failed conventional medical management.
"Osteoporosis patients who have persistent spinal pain lasting more than three months should consult an interventional radiologist, and those who require constant narcotic pain relief should seek help immediately," noted Anselmetti. The treatment was completed in all patients without major complications and with good clinical results. The data add to the body of evidence in the United States for the minimally invasive treatment's safety, effectiveness and low-complication rate. The treatment is widely available in the United States at all major institutions and many smaller institutions and is generally covered by health insurance.
The study also showed that vertebroplasty does not increase the risk of fracture in nearby vertebra. "Vertebroplasty is already known to be a safe and effective treatment for osteoporotic vertebral fractures. Osteoporosis patients remain susceptible to new fractures, which often occur in the contiguous vertebra to an existing fracture. Our large-scale study shows that vertebroplasty does not increase the risk of fracture in the level contiguous to previously treated vertebra and that these new fractures occur at the same rate as they would in osteoporosis patients who did not have vertebroplasty," added Anselmetti.