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Prospective Analysis of Clinical Outcomes After Percutaneous Vertebroplasty For Painful Osteoporotic Vertebral Body Fractures 2004

Do, Huy, M.D., Kim, Brian, M.D., Curtis, Lisa, M.D., Marcellus, Mary, M.D., Marks, Michael, M.D.

Purpose:
Previous studies have retrospectively evaluated the beneficial effects of percutaneous vertebroplasty. The purpose of our study is to prospectively evaluate the beneficial effects of percutaneous vertebroplasty on mobility, analgesic use and pain scale for patients with painful osteoporotic vertebral compression fractures that are refractory to medical therapy. Our study also aims to evaluate the short and long-term health benefits of percutaneous vertebroplasty using various SF-36 survey health scales.

Methods and Materials:
We performed a prospective study by treating 167 patients and performing a total l of 210 vertebroplasties between August 1999 and January 2003. The average age of patients was 74.6 years with a standard deviation of 12.2 years and 75% of the patients were women. Pre-procedural measurements of pain, mobility and analgesic use were compared with post-procedural measurements of these same scales one month after the procedure. Pre-procedural measurements of SF-36 health survey scales were also compared with post-procedural measurements one month and six months to three years after the procedure.

Results:
Pre-treatment pain score average was 8.71 with SE of 0.1, while post-treatment pain score average was 2.77 with SE of 0.18 (p<0.00001). Pre-treatment analgesic use average was 2.93 with SE of 0.9, while post-treatment analgesic use average was 1.64 with SE of 0.09 (p<0.00001). Pre-treatment activity level average was 2.66 with SE of 0.1, while post-treatment activity level average was 1.46 with SE of 0.11 (p<0.00001).

There was a statistically significant improvement (p<0.001) on nine out of ten SF-36 health scales at one-month follow-up and a statistically significant improvement (p<0.02) on eight out of ten SF-36 health scales at six month or long-term follow-up.

Conclusions:
Percutaneous vertebroplasty offers tremendous and statistically significant benefits in decreasing pain, decreasing use of analgesics and increasing mobility in appropriately selected patients. Percutaneous vertebroplasty also offers a statistically significant benefit in most SF-36 health scales at both short and long term follow-up.