Abstract:
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Purpose: To determine the efficacy of percutaneous vertebroplasty in restoring vertebral body height and reducing spinal deformity in patients with osteoporotic and pathologic compression fractures.
Methods and Materials: A retrospective review of percutaneous vertebroplasties yielded 47 vertebrae in 27 patients treated with vertebroplasty. The extent of vertebral body collapse was measured from the height of the maximum collapse on lateral radiographs or midsagittal MR images. Fracture angulation was measured for midthoracic compression fractures from the superior endplate of the vertebral body one level above the injured vertebral body to the inferior endplate of the vertebral body one level below. The location of involved vertebra and pattern of vertebral compression were also assessed. Lateral radiographs or reformatted midsagittal CT images obtained after the procedure were viewed to calculate vertebral body collapse at all levels, and spinal angulation for fractures in the midthoracic spine.
Results: A total of 47 vertebrae in 27 patients (9 males and 18 females, aged 41-87 years) were treated. Thirty-seven levels were treated with a modified unipediculate approach while remaining levels were treated with a standard bipediculate approach. Involved vertebrae were located from levels T5 to L5. Pattern of vertebral compression included gibbus (31 of 47, 66%), plana (6 of 47, 13%), and H-shaped (10 of 47, 21%). The extent of vertebral body collapse averaged 51% (range, 12% to 86%) of overall height. Fracture angulation averaged 32 degrees (range, 11 degrees to 70 degrees). The extent of vertebral body collapse postprocedure averaged 28% (range, -16% to 59%, p < 0.001). Fracture angulation postprocedure averaged 28 degrees (range, 6 degrees to 57 degrees, p < 0.05).
Conclusion: Vertebroplasty is a minimally invasive procedure for the treatment of painful osteoporotic and pathologic vertebral compression fractures. Despite what the literature suggests, vertebroplasty is efficacious in restoring vertebral body height and eliminating spinal deformity.
Freeman MD, M,
Percutaneous Vertebroplasty Results in the Reversal of Height Loss and Spinal Deformity in Patients with Osteoporotic and Pathologic Compression Fractures. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3101637.html
