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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2024; 08(01): 022-028
DOI: 10.1055/s-0043-1777864
Original Article

Effectiveness of Vertebroplasty and Kyphoplasty for Pain Reduction in Patients with Sarcopenia and Osteoporosis

John H. Schilling 
1   Department of Radiology, Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado, United States
,
David Gimarc
1   Department of Radiology, Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado, United States
,
Nicholas M. Pflederer
1   Department of Radiology, Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado, United States
,
Jack Pattee
2   University of Colorado Center for Innovative Design and Analysis, Aurora, Colorado, United States
,
Michael Durst
1   Department of Radiology, Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado, United States
,
MK Jesse
1   Department of Radiology, Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado, United States
,
James Korf
1   Department of Radiology, Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado, United States
,
Amanda Crawford
3   Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah, United States
,
Corey K. Ho
1   Department of Radiology, Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado, United States
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Abstract

Purpose Vertebral compression fractures (VCFs) are common and associated with high morbidity including severe, debilitating pain. Percutaneous vertebroplasty/kyphoplasty is a demonstrated effective treatment for VCF. Sarcopenia has been implicated as a risk factor for VCF and refracture following cement augmentation, and as a risk factor for procedural complications in some populations; however, the effect of sarcopenia on VCF patients undergoing these procedures is unknown. This study aims to improve outcomes and patient selection by investigating the effects of highly common VCF comorbidities.

Methods A retrospective study was performed of all patients who underwent vertebroplasty/kyphoplasty for treatment of VCF at a single center from 2007 to 2020. Sarcopenia was quantified by normalized total psoas area (TPA) as measured on computed tomography. The effect of sarcopenia, bone density t-score, and clinical and demographic covariates on periprocedural pain scores was evaluated with linear mixed-effects models.

Results Out of 458 procedures performed, 146 and 130 were included in the sarcopenia and osteoporosis analyses, respectively. Sarcopenia and osteoporosis were highly comorbid in VCF patients undergoing vertebroplasty/kyphoplasty. Linear mixed-effects modeling showed no significant association between change in pain score and TPA score (p = 0.827) or bone density t-score (p = 0.818).

Conclusion Postprocedural pain reduction after vertebroplasty/kyphoplasty is not associated with the presence or severity of sarcopenia or osteoporosis/osteopenia. Appropriate patient selection remains critical to optimize the risk–benefit ratio of vertebroplasty/kyphoplasty, and sarcopenia and osteoporosis should not be considered contraindications to these procedures.

Keywords

kyphoplasty - sarcopenia - osteoporosis

Ethical Approval

The study was performed after approval of an institutional review board.




Publication History

Article published online:
30 January 2024

© 2024. 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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