Safety and efficacy of vertebroplasty in the treatment of osteoporotic vertebral compression fractures: a prospective multicenter international randomized controlled study.

Autor: Leali PT; Orthopaedic Department, University of Sassari, Sassari, Italy., Solla F; Orthopaedic Department, Paediatric Hospital Nice CHU-Lenval, France., Maestretti G; Spinal Unit, Cantonal Hospital Fribourg, Switzerland., Balsano M; Orthopaedic Department, Santorso Hospital AUSSL 4, Schio, Italy., Doria C; Orthopaedic Department, University of Sassari, Sassari, Italy.
Jazyk: angličtina
Zdroj: Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases [Clin Cases Miner Bone Metab] 2016 Sep-Dec; Vol. 13 (3), pp. 234-236. Date of Electronic Publication: 2017 Feb 10.
DOI: 10.11138/ccmbm/2016.13.3.234
Abstrakt: Background: Vertebral compression fractures (VCFs) treated non-operatively can diminish function and quality of life, and lead to chronic health effects. The short-term safety and effectiveness of vertebroplasty for symptomatic VCFs are well-documented, but long-term follow-up is needed.
Purpose: The aim of this paper was to analyse a multicenter international experience of 200 compression fractures treated with percutaneous vertebroplasty (VP) and compare the results of this procedure with the result of 200 patients treated conservatively. To estimate cost-effectiveness of VP compared to conservative care in terms of: pain reduction, quality of life, complications, secondary fractures and mortality.
Materials and Methods: 400 patients have been enrolled in a prospective randomized controlled study with painful VCFs with bone edema on MR imaging, local back pain for 6 weeks or less, osteoporosis and aged 55 years or older; after obtaining informed consent patients are included and randomized for VP or conservative care. Before treatment and at follow-up with regular intervals during 1-year period were administered to patients standard questionnaires addressing: clinical symptoms, pain medication, Visual Analogue Scale (VAS) score for pain, Oswestry Disability Index (ODI) score to evaluate functional activity.
Results: 200 patients treated with PV compared with 200 patients treated conservatively had significantly better VAS and used less analgesics 1 day after treatment. Twenty-four hours after VP, there was a reduction in pain scores and an improvement in physical functions, whereas remain unchanged in the patients treated conservatively.
Conclusions: Pain relief and improvement of mobility and function after PV is immediate and significantly better in the short term compared with non-surgical care treatment.
Databáze: MEDLINE
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