Treatment of osteoporotic spinal compression fractures with percutaneous vertebroplasty

Objective To evaluate the curative effect and problems of X-ray fluoroscopy guided percutaneous vertebroplasty (PVP) in treating osteoporotic spinal compression fractures. Methods Twenty-four patients (15 females and 8 males) with 44 vertebral compression fractures underwent PVP. They were average 69 years of age (48-83 years). The fracture segment was within T 5-L 3 (20 thoracical vertebrae, 24 lumbar vertebrae). Under the guidance of C-arm fluoroscopy, bone marrow biopsy needle was inserted percutaneously via transpedicular way into the fractured vertebrae. Polymethylmethacrylate (PMMA) was then injected into the fractured vertebrae. Vasual analogue scale (VAS), mobility and analgesic usage were evaluated 2 days before and after PVP and in the follow-up period. Results PVP was successful in 21 cases (40 vertebrae ), but failed in 2 cases (4 vertebrae) due to weak position endurance. The volume of PMMA injected was 1.0-8.0 ml per vertebrae. The average follow-up period was 3.1 months (1-7 months). VAS was sharply decreased from pre-PVP 7.5±1.2 to 2.8±1.0 at day 2 after PVP (P0.001). It decreased slightly to 2.3± 0.9 during the follow-up period at day 2 after operation. Scale of patient's mobility was increased from pre-PVP 2.3± 0.8 to 1.6± 0.3 at day 2 after PVP with a significant difference (P 0.05). It was 1.4± 0.4 during the follow-up period and the mobility improved further. Scale of analgesic usage changed from 2.2± 0.5 before PVP to 0.6± 0.6 2 days after PVP with a significant difference (P 0.01), and was 0.8± 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 with a C-arm single-plane fluoroscopy in most cases.