CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2021; 5(02): 072-078
DOI: 10.1055/s-0041-1729777
Original Article

Efficacy of Percutaneous Vertebroplasty in the Treatment of Malignant and Benign Vertebral Fractures: Single-Center Experiences

1   Department of Radiology, Bursa Uludag University School of Medicine, Bursa, Turkey
,
Bahattin Hakyemez
1   Department of Radiology, Bursa Uludag University School of Medicine, Bursa, Turkey
› Author Affiliations

Abstract

Percutaneous vertebroplasty (PVP) is a method used for vertebral stabilization and pain treatment. This study was performed to demonstrate the efficacy of PVP in treatment of malignant and benign vertebral compression fractures (VCFs). The study was conducted on 45 cases with a total of 106 VCFs. The mean age of the patients was 62.4 years (37–86 years). The vertebral fractures were classified according to Genant’s Classification. Pain was rated using the visual analog scale (VAS). VAS scores were recorded before and after PVP operations. A total of 58 vertebrae (54.8%) were treated via a bipedicular approach, and 48 vertebrae (45.2%) were treated via a unilateral transpedicular approach with the help of biplane imaging and under anesthesia. L1 vertebra (19.8%) fractures and Grade III fractures (46.3%) were more common. Vertebral collapse was the most common cause of malignancy (53.8%). The mean VAS score was measured to be 8.39 before the VP operations and 2.05 after the VP operations. The VAS score dropped to 2.3 through the unipedicular approach and to 1.84 through the bipedicular approach. The decrease in pain due to VP was statistically significant (p < 0.001). There was no statistically significant difference between the unipedicular and bipedicular approaches in terms of pain relief (p> 0.05). Some patients (18.8%) had complications. PVP is a highly therapeutic method for pain relief in case of pain secondary to malignant or benign vertebral fractures.



Publication History

Article published online:
18 May 2021

© 2021. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Johnell O, Kanis J. Epidemiology of osteoporotic fractures. Osteoporos Int 2005; 16 (Suppl. 02) S3-S7
  • 2 Mut M, Schiff D, Shaffrey ME. Metastasis to nervous system: spinal epidural and intramedullary metastases. J Neurooncol 2005; 75 (01) 43-56
  • 3 Wong DA, Fornasier VL, MacNab I. Spinal metastases: the obvious, the occult, and the impostors. Spine 1990; 15 (01) 1-4
  • 4 Watts NB, Harris ST, Genant HK. Treatment of painful osteoporotic vertebral fractures with percutaneous vertebroplasty or kyphoplasty. Osteoporos Int 2001; 12 (06) 429-437
  • 5 Bostrom MP, Lane JM. Future directions. Augmentation of osteoporotic vertebral bodies. Spine 1997; 22 (24 Suppl) 38S-42S
  • 6 Cooper C, Atkinson EJ, O’Fallon WM, Melton III LJ. Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985-1989. J Bone Miner Res 1992; 7 (02) 221-227
  • 7 Truumees E, Hilibrand A, Vaccaro AR. Percutaneous vertebral augmentation. Spine J 2004; 4 (02) 218-229
  • 8 Genant HK, Wu CY, van Kuijk C, Nevitt MC. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 1993; 8 (09) 1137-1148
  • 9 Logas WG, el-Baz N, el-Ganzouri A. et al. Continuous thoracic epidural analgesia for postoperative pain relief following thoracotomy: a randomized prospective study. Anesthesiology 1987; 67 (05) 787-791
  • 10 Watanabe S, Koyama K. Visual analogue pain scale with convenient digitizer. Anesthesiology 1989; 71 (03) 481-482
  • 11 Gracely RH. Methods of testing pain mechanisms in normal man. In: Wall PD, Melzack R, eds. Textbook of Pain.. Singapore: Churchill Livingstone 1989; 257
  • 12 Benyamin R, Vallejo R. Vertebroplasty. Tech Reg Anesth Pain Manage 2005; 9: 62-67
  • 13 McKiernan F, Faciszewski T, Jensen R. Quality of life following vertebroplasty. J Bone Joint Surg Am 2004; 86 (12) 2600-2606
  • 14 Cook DJ, Guyatt GH, Adachi JD. et al. Quality of life issues in women with vertebral fractures due to osteoporosis. Arthritis Rheum 1993; 36 (06) 750-756
  • 15 Silverman SL. The clinical consequences of vertebral compression fracture. Bone 1992; 13 (Suppl. 02) S27-S31
  • 16 Yeom JS, Kim WJ, Choy WS, Lee CK, Chang BS, Kang JW. Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures. J Bone Joint Surg Br 2003; 85 (01) 83-89
  • 17 Hide IG, Gangi A. Percutaneous vertebroplasty: history, technique and current perspectives. Clin Radiol 2004; 59 (06) 461-467
  • 18 Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion JE. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol 1997; 18 (10) 1897-1904
  • 19 Tohmeh AG, Mathis JM, Fenton DC, Levine AM, Belkoff SM. Biomechanical efficacy of unipedicular versus bipedicular vertebroplasty for the management of osteoporotic compression fractures. Spine 1999; 24 (17) 1772-1776
  • 20 Cotten A, Dewatre F, Cortet B. et al. Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up. Radiology 1996; 200 (02) 525-530
  • 21 Mehbod A, Aunoble S, Le Huec JC. Vertebroplasty for osteoporotic spine fracture: prevention and treatment. Eur Spine J 2003; 12 (Suppl. 02) S155-S162
  • 22 Heini PF, Wälchli B, Berlemann U. Percutaneous transpedicular vertebroplasty with PMMA: operative technique and early results. A prospective study for the treatment of osteoporotic compression fractures. Eur Spine J 2000; 9 (05) 445-450
  • 23 Cheng-Ta H, Jui-Ming S, Shih-Youeng C, Ming-Ying L, Da-Tong J. Pain relief in patients treated with percutaneous vertebroplasty: an evaluation cement volume. J Neurol Sci 2008; 25: 266-271
  • 24 Padovani B, Kasriel O, Brunner P, Peretti-Viton P. Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty. Am J Neuroradiol 1999; 20 (03) 375-377
  • 25 Linville DA II. Vertebroplasty and kyphoplasty. South Med J 2002; 95 (06) 583-587
  • 26 Phillips FM, Todd Wetzel F, Lieberman I, Campbell-Hupp M. An in vivo comparison of the potential for extravertebral cement leak after vertebroplasty and kyphoplasty. Spine 2002; 27 (19) 2173-2178
  • 27 Mousavi P, Roth S, Finkelstein J, Cheung G, Whyne C. Volumetric quantification of cement leakage following percutaneous vertebroplasty in metastatic and osteoporotic vertebrae. J Neurosurg 2003; 99 (Suppl. 01) 56-59
  • 28 Ratliff J, Nguyen T, Heiss J. Root and spinal cord compression from methylmethacrylate vertebroplasty. Spine 2001; 26 (13) E300-E302
  • 29 Schmidt R, Cakir B, Mattes T, Wegener M, Puhl W, Richter M. Cement leakage during vertebroplasty: an underestimated problem?. Eur Spine J 2005; 14 (05) 466-473
  • 30 Vasconcelos C, Gailloud P, Beauchamp NJ, Heck DV, Murphy KJ. Is percutaneous vertebroplasty without pretreatment venography safe? Evaluation of 205 consecutives procedures. AJNR Am J Neuroradiol 2002; 23 (06) 913-917
  • 31 Rao RD, Singrakhia MD. Painful osteoporotic vertebral fracture. Pathogenesis, evaluation, and roles of vertebroplasty and kyphoplasty in its management. J Bone Joint Surg Am 2003; 85 (10) 2010-2022
  • 32 Grados F, Depriester C, Cayrolle G, Hardy N, Deramond H, Fardellone P. Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheumatology (Oxford) 2000; 39 (12) 1410-1414
  • 33 Zoarski GH, Snow P, Olan WJ. et al. Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. J Vasc Interv Radiol 2002; 13 (02/01) 139-148
  • 34 McGraw JK, Lippert JA, Minkus KD, Rami PM, Davis TM, Budzik RF. Prospective evaluation of pain relief in 100 patients undergoing percutaneous vertebroplasty: results and follow-up. J Vasc Interv Radiol 2002; 13 (9 Pt 1) 883-886
  • 35 Peh WC, Gilula LA, Peck DD. Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Radiology 2002; 223 (01) 121-126