Multiple-level vertebral body compression fractures treated with percutaneous vertebroplasty

Objective:To evaluate the effectiveness and procedure of C-arm fluoroscopy-guide percutaneous vertebroplasty(PVP) for the treatment of multiple level vertebral body compression fractures.Methods:Seven cases(5women and 2 men) suffering from multiple level vertebral body compression fractures( range 3-9 levels), underwent 3 to 6 levels' PVP guided by a single plane C-arm fluoroscopy in prone position or lateral recumbent position.The age of cases was from 60 to 79.Visual analgesic scale(VAS), analgesic use and mobility were measured in each patient at pre-PVP, 2 days post-PVP and 4 months post-PVP.Results:PVP procedures were successful in prone position of 2 cases and in lateral recumbent position of 5 cases.The time consumed by PVP in each patient was from 2.0 to 4.5 hours. Unipedicular approach was used in 16 fractured vertebrae and bipedicular approach in 9 fractured ones.The volume of polymethylmethacrylate(PMMA) injected into each vertebral body was from 0.5 ml to 4.0 ml.In all 7 cases, the procedure increased mobility and decreased analgesic use ( T=0,P 0.01).VAS was decreased for a mean of 5.1(range 2.1-6.4)from pre-PVP to 2 days post-PVP( t=7.4,P 0.0005),and maintained almost the level at 4 months post-PVP.Conclusion:Multiple-level vertebral body compression fractures could be treated with PVP effectively,and the useful method to perform PVP for those patients is to treat multiple levels in one time,in lateral recumbent position and by C-arm fluoroscopic guidance.