Abstract
Introduction The aim of this study was to assess the effectiveness of percutaneous vertebroplasty as an invervention therapy in symptomatic vertebral compression fractures on pain relief and improvement of the quality of life of the patients. The increasing elderly population is assumed to be associated with an increased incidence of osteoporotic vertebral compression fractures. These fractures lead to a severe morbidity, decreasing quality of life, worsening co-morbidity and sometimes resulting in death. It is justifiable to treat stable vertebral compression fractures by non-operative therapy. Previous studies have shown that vertebroplasty as a non-operative treatment increases the vertebral body strength, restores vertebral body stiffness, reinforces fractured bone, prevents further deformity and alleviates the local pain. Complication rates are reputed to be low.
Methods This is a prospective clinical study of percutaneous vertebroplasty in treating stable vertebral compression fractures. Since January 2001, 30 patients were treated by percutaneous vertebroplasty for 58 osteoporotic compression vertebral fractures, four non-osteoporotic stable compression fractures, two compression vertebral fractures due to metastatic carcinoma of the prostate and one due to metastatic carcimona of the cervix. Bone cement PMMA (Howmedica) mixed with Vancomycin antibiotic, and Tantalum Dust Powder (Cook Medical Co) was inserted to the facture site using Oseo-Site Bone Biopsy needle (Cook Medical Co). Pre and post treatment pain, morbidity, quality of life, hospital stay, complication and long term results were evaluated.
Results The average hospital stay after vertebroplasty was 2.2 days. Signficant pain relief from 9.9 (pain scale) to 1.8. Improvement of the quality of life: siting, standing, walking without a lumbar brace was achieved one day after the treatment. In some cases the delay of improvement was influenced by the co-morbidity of the patients. No complications were found during the procedure of this treatment.
Conclusions Vertebroplasy provided a promisingly good result in alleviating the local pain and improving the quality of life in osteoporotic thoraco-lumbar compression fractures. Prospective and long term results should be evaluated in greater sample size for non osteoporotic stable compression fractures. Although vertebroplasty does not change the nature of carcinoma, it improves the rest of the quality of life of someone suffering from metastatic fractures.
In relation to the conduct of this study, one or more of the authors has received, or is likely to receive direct material benefits.
The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.
