Vertebroplasty for vertebral compression fracture.

ABSTRACT

The patients with intensive pain caused by the vertebra body fracture were treated by application of bone cement under local or general anesthesia, by means of diascopy through unilateral transpedicular approach. The intensity of pain was followed-up on the VAS scale before surgery, 24 hours after surgery and three months after surgery. The cement was applied in 55 patients (43 women, 12 men). The average age of the tests was 68.43 years (38 to 82 years). Fifty five procedures were implemented on 85 vertebrae, i.e. 32 metastatic fractures and 23 osteoporotic fractures. The procedures were applied on 28 thoracal and 57 lumbar vertebrae. The average VAS before surgery was 8.36 and 2.23 (p < 0.005) 24 hours after surgery, and it remained almost unchanged three months later. There were 1 serious complication, a paraparesis caused by the leakage of cement into the spinal canal, which was partially recovered after decompression and rehabilitation treatment, and 2 superficial infections with S. epidermidis which were cured by means of antibiotics. By means of Wilcoxon paired test a significant difference was found between the preoperative VAS and the value 24 hours after surgery (n = 55, Z = 6.451, p < 0.00001) and 3 months after surgery (Z = 6.45, p < = 0.00001), while there was a compliance between two VAS measurements after surgery (Z = 1.308, p = 0.191) which indicates that the fast pain reduction remained stable during the 3 month follow-up. The vertebroplasty is a safe and efficient surgical method in treatment of compressive vertebrae fractures which do not react to the conventional method of treatment. The achieved analgesic effect 24 hours after surgery is a good predictor of pain intensity 3 months after surgery.