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Prospective Analysis of Clinical Outcomes After Percutaneous Vertebroplasty for Patients with Kummell Disease 2004

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

Background and Purpose:
The purpose of our study is to prospectively evaluate the beneficial effects of percutaneous vertebroplasty on mobility, analgesic and pain scale for patients with vertebral compression fractures associated with osteonecrosis (Kummell’s disease) that are refractory to medical therapy. Our directional hypothesis is that vertebroplasty offers significant clinical benefits in appropriately selected Kummell’s patients.

Methods:
We prospectively followed 45 patients treated with 63 ve rtebroplasties between July 1999 and January 2003. The average age of patients was 80.3 years with a standard deviation of 7.3 years and 73% of the patients were women. Pre-procedural measurements of pain, mobility and analgesic use were compared with post-procedural measurements of these same scales. Follow up data was obtained at one month post-treatment.

Results:
Pre-treatment pain score average was 8.91 with SE of 0.15, while post-treatment pain score average was 2.84 with SE of 0.34 (p<0.0001). Pre-treatment analgesic use average was 2.68 with an SE of 0.16, while post-treatment analgesic use average was 1.38 with SE of 0.14 (p<0.001). Pre-treatment activity level average was 2.82 with SE of 0.17, while post-treatment activity level average was 1.61 with SE of 0.16 (p<0.001).

Conclusion:
Percutaneous vertebroplasty offers statistically significant benefits by decreasing pain, decreasing use of analgesics and increasing mobility in appropriately se lected Kummell\'s patients presenting with vertebral compression fractures that are refractory to medical therapy.