Treatment of osteoporotic spinal compression fractures by percutaneous vertebroplasty

Objective To evaluate the tharapeutic effect of percutaneous vertebroplasty (PVP) guided by fluoroscopy in treating osteoporotic spinal compression fractures. Methods Twenty-nine patients (17 females and 12 males) with 40 vertebral compression fractures underwent PVP. They were 67 years of age on an average (45-84 years). The fracture segment was within T_3-L_5 (13 thoracical vertebrae, 27 lumbar vertebrae). Under the guidance of C-arm fluoroscopy, bone marrow biopsy needle was inserted percutaneously viavertebral pedicle into the fractured vertebral body. Polymethylmethacrylate (PMMA) was then injected into the fractured vertebrae. Visual analogue scale (VAS), mobility and analgesic usage were evaluated 3 days before and after PVP and in the follow-up period. Results PVP was successful in 29 cases (40 vertebrae). VAS was sharply decreased from 7.8±1.4 pre-PVP to 2.5±1.0 at day 3 after PVP (P0.001); it decreased slightly to 2.1±0.8 during the follow-up period. Scale of patient's mobility was increased from 2.5±0.7 pre-PVP to 1.6±0.3 at day 3 after PVP with a significant difference (P0.05); it was 1.3±0.5 during the follow-up period and improved further. Scale of analgesic usage changed from 2.3±0.6 before PVP to 0.7±0.6 3 days after PVP with a significant difference (P0.01), and was 0.6±0.6 during the follow-up period without significant difference compared with post PVP. Conclusions PVP is an effective mini-invasive technique for osteoporotic spinal compression fractures and can be accomplished safely wnder C-arm single-plane fluoroscopy in most cases.