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Outcome Comparison between Percutaneous Vertebroplasty and Conservative Treatment in Acute Painful Osteoporotic Vertebral Compression Fracture

  • Journal of Korean Society of Spine Surgery
  • Abbr : J Kor Spine Sur
  • 2014, 21(2), pp.70-75
  • Publisher : Korean Society Of Spine Surgery
  • Research Area : Medicine and Pharmacy > Orthopedic Surgery

나화엽 1,  Young-Sang Lee 1,  박태훈 1,  김태환 1,  서강원 1

1분당제생병원 정형외과

Accredited

ABSTRACT

Study Design: A retrospective comparative study. Objectives: To compare the outcome of percutaneous vertebroplasty (VP) and conservative treatment for the treatment of acute painfulosteoporotic vertebral compression fractures (VCF). Summary of Literature Review: Vertebroplasty is a common procedure for the treatment of acute painful osteoporotic VCF. However,controversy still exists regarding clinical outcomes of the procedure compared with more conservative treatment. Material and Methods: A consecutive group of patients, undergoing VP and conservative treatment at our hospital, between July 2005and October 2008, were reviewed retrospectively. All patients were reviewed with at least 1 year of follow up. A total of 58 patientsunderwent 59 VP procedures under local anesthesia at post injury 2 weeks; a total of 31 underwent conservative treatment. These twogroups were compared by the kyphotic angle and loss of vertebral body height at immediate post-injury, post-injury 6weeks and 1y ear,radiologically. And they were compared by the visual analog scale(VAS) score and ambulatory status at the same time, clinically. Results: At the time of immediate post-injury, six weeks after post-injury, one year after injury, height loss was 29.73%, 19.81%, 22.59%in the VP group, respectively, and 31.20%, 36.80%, 40.60% in the conservative treatment group, respectively. The Kyphotic angles were13.44°, 9.10°, 11.31° in VP group, respectively, and 10.29°, 15.83°, 19.00° in the conservative treatment group, respectively. There was a statistically significant reduction of height loss and kyphotic angle in VP group at post-injury of 6 weeks and 1 year(p<0.05). At the same time, VAS scores were 9.41, 4.32, 2.47 in the VP group, respectively, and 9.50, 6.25, 2.71 in conservative treatment group,respectively. Ambulation status was 3.61, 1.46, 1.22 in the VP group, respectively, and 3.65, 2.45, 1.32 in the conservative treatmentgroup, respectively. There was a statistically significant reduction of VAS score and improved ambulation status in VP group at post-6weeks, but no difference between two groups at post 1 year. There was no significant difference in new fractures of adjacent vertebraebetween the two groups (p>0.05). Conclusions: VP prevents further collapse and kyphosis relieves pain quickly and allows early ambulation, but in post-injury 1 yearfollow up, there was no significant difference in clinical outcomes. Proper treatment should be done with respect to patient’s age, generalcondition, economic status and complication. Key Words: Vertebral compression fracture, Osteoporosis, Vertebroplasty, Conservative treatment

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