Abstract
Osteoporosis and osteoporotic fractures represent a growing medical and socioeconomic problem and the spine is the most common site for this kind of fracture. Back pain is the leading symptom with progressive loss of stature and restricted physical activity as a consequence. Vertebroplasty – percutaneous cement reinforcement of osteoporotic vertebrae - represents a new treatment alternative.
During a three year period, 512 vertebrae in 180 patients were reinforced for osteoporotic fractures with low viscosity PMMA. One to eight levels were treated per time, and 8ml (2–18ml) of PMMA per vertebra were injected. The patients’ pain (VAS) was prospectively monitored before surgery, one day, 3 months and one and two years postoperatively. Furthermore, X-rays were analysed 3, 12 and 24 months postoperatively.
One out of 180 patients suffered from an L2 root irritation due to cement leakage that subsided after steroid infiltration. 52 patients with 144 levels treated and a minimal follow up of two years showed a significant (p< 0.02) and lasting pain reduction from 7.7 to 2.8 points at two years. 6 patients were treated a 2nd time for a new fracture. The reinforced vertebrae remained stable without further sintering.
Vertebroplasty is efficient for the treatment of osteoporotic vertebral fractures. The injection technique used is safe, easy and fast. An unsolved problem remains the question about the importance of prophylactic reinforcement of non-fractured vertebrae.
The abstracts were prepared by Dr C Pither. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PN
Heini P.F., Wälchli B., Berlemann U. Percutaneous transpedicular vertebroplasty with PMMA: operative technique and early results. A prospective study for the treatmentof osteoporotic compression fractures. Eur Spine J ( 2000) 9 : 445–450 Google Scholar
