Percutaneous vertebroplasty in vertebral compression fractures of benign or malignant origin: a prospective study of 1188 patients with follow-up of 12 months.

BACKGROUND: Vertebral body fractures are a source of high costs for the health care system and will continue to be one as the population ages. Cost-effective treatment is thus all the more important. In this study, we evaluated patients' quality of life during the first 12 months after they had undergone percutaneous vertebroplasty for vertebral body fractures which were refractory to conservative treatment. Our analysis took the causes of the fractures into account. METHODS: Pain, mobility, and need for analgesics were assessed prospectively on verbal rating scales one day before and one day after vertebroplasty, as well as over a follow-up period of up to 12 months. The same examiner interviewed each patient at all time points to obtain this information. RESULTS: 1188 patients underwent vertebroplasty for 1980 vertebral body fractures; the most common etiology was osteoporosis (75%). There was statistically relevant improvement in all three of the variables studied from the day before the procedure to the last follow-up, regardless of the cause of fracture (p<0.01). Most of the clinical benefit was already evident on the day after the procedure. Patients with fractures due to osteoporosis experienced further statistically relevant improvement by 6 months after treatment. CONCLUSION: Percutaneous vertebroplasty immediately relieves the pain of vertebral body fractures, improves patients' mobility, and lowers their consumption of analgesics. There can be further clinical improvement up to 6 months after the procedure, particularly in patients with fractures due to osteoporosis. As osteoporosis is the most common cause of vertebral body fractures, this patient group is important not just clinically, but economically as well.