Pain relief after vertebroplasty for osteoporotic and osteolytic compression fractures

ABSTRACT

To find out the role of percutaneous cement vertebroplasty [PCV] in osteoporotic and osteolytic compression fractures of the vertebral bodies using polymethyl methacrylate [PMMA] bone cement in early pain relief. Quasi-experimental study. This study was conducted in Spinal Unit, Orthopaedic Department, Combined Military Hospital, Rawalpindi, Pakistan from Nov 2005 to May 2007. Ten patients with sixteen osteoporotic and osteolytic fractures were treated with PCV using PMMA. Seven patients out of these had osteoporotic vertebral compression fractures [OVCF] and three had compression fractures secondary to spinal metastases [SM]. Six patients were males and four were females. Average age among OVCF was 66 years and among SM was 54 years. Patients were followed up on 1[st] post op day, two weeks and six weeks after PCV Patient satisfaction, relief in pain, early mobilization, restoration of vertebral height and complications were noted. Nine out of ten patients were fully satisfied with PCV Eight patients had excellent pain relief [p value < 0.001]. Eight patients were mobilized within two hours of the procedure. There was one major cement leak inside spinal canal causing paraparesis. In this patient immediate exploration, decompression and pedicle screw fixation was done. He had complete neurological recovery post-operatively. Three patients had minor asymptomatic cement leaks. One patient had prolonged ileus, which settled ultimately. In carefully selected cases, PCV is shown to be very efficacious in relieving the pain associated with both osteoporotic and osteolytic compression fractures. It is a minimally invasive procedure that has gained widespread acceptance as the standard of care for compression fractures unresponsive to traditional forms of treatment