Ahmed Fadl MD, Presenter: Nothing to Disclose

Carla Alexis de Venecia MD, Abstract Co-Author: Nothing to Disclose

A. Orlando Ortiz MD, MBA, Abstract Co-Author: Nothing to Disclose

To determine if percutaneous vertebral augmentation (PCA) provides long -term stability without significant changes in height over time in patients treated for osteoporotic compression fractures. 

A single institution PACS database query was conducted to determine the number of patients who underwent either vertebroplasty or kyphoplasty for back pain secondary to vertebral osteoporosis induced compression fracture. Augmented vertebral height measurements were analyzed from images during pre-intervention, immediate post-intervention, and at varying points during follow up examinations. Vertebral height measurements were measured and standardized against an internal control depending on the imaging modality. Controls were designated using a stable vertebral body and/or  using an imaging device of a known constant dimension. The ratio of heights between two values (injected vertebral body versus internal control) were recorded over time and compared to other ratio values at various time intervals. 

45 patients met inclusion criteria (42 women / 3 men) with the distribution of kyphoplasty to vertebroplasty being 48 and 77 respectively. Of the 45 patients, 110 vertebral bodies were augmented. 41 of the 45 were on supplemental pharmocologic management for osteoporosis. Average imaging follow up was 4.7 years. All augmented vertebral bodies demonstrated adequate endplate-to-endplate filling. Follow-up imaging of the 110 injected vertebral bodies demonstrated no statistically significant change in vertebral height over time with a p-value of 0.46. 

The findings of the study demonstrate that vertebral augmentation yields stable vertebral bodies with no change in overall vertebral body height over time. There was no statistically significant difference between the two techniques or pharmacologic treatment. Limitations of the project included comparison of relative vertebral heights versus absolute values. Further analysis utilizing a prospective cohort with absolute internal controls is needed to further add validitiy to the current findings.

The findings of the study provide clinical evidence to support that percutaneous vertebral augmentation provides long term stability with respects to height for those patients with osteoporotic induced vertebral compression fractures.

Fadl, A, de Venecia, C, Ortiz, A, Long Term Height Maintenance of the Percutaneous Augmented Vertebral Body for the Treatment of Symptomatic Osteoporotic Compression Fractures.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045463.html