The clinical significance of repeat PVP for treatment of osteoporotic vertebral compression fractures

Objective To investigate the reason why there is no pain-relief to patient with osteoporotic vertebral compressive fractures who undergoing vertebroplasty and examine if a repeat PVP is effective on pain-relief to these patients. Methods There are 9 patients with unrelieved pain after an initial PVP in this group, the mean age is 72.3±7.4, the compressive rate of the vertebrae range 34% ~ 56 %, and the preoperative visual analog scale score(VAS) score is 8.12±1.40. A repeat vertebroplasty were performed to these 9 patients.The VAS score was use the measure the effective on pain-relief in these patients. Result The mean volume of Polymethylmethacrylate injected in each vertebra was (2.1±1.0)ml in the repeat PVP. During the first month of follow-up after repeat PVP in this series, a mean VAS is 2.7±0.9. After a 9~18 (mean 12±3.5)months follow-up, the Complete and partial pain-relief were reached in 5 and 4 patients. No serious complications related to the proceduresoccurred.Conclusions A repeat PVP is effective at the same vertebral levels in patients without pain-relief who underwent first time PVP. Inadequate or absent filling of cement in the unstable fractured areas of the vertebral body may be the reason for the unrelieved pain after the initial PVP.