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Subsequent Vertebroplasty For A New Fracture Has The Same Prognosis As The Initial Procedure 2003

Oka M, Westesson PL.
University of Rochester
Rochester, NY

Purpose:
To study the prognosis of subsequent vertebroplasties for new fractures.

Methods:
We compared the results of 36 initial vertebroplasties with 15 subsequent vertebroplasties performed for patients who returned with a new fracture. We recorded pain, use of pain medication and mobility before and at follow-up (average 5.3 months). We graded pain as no pain (0), minimal (1), mild (2), intermediate (3), moderate (4), severe (5) or extreme (6), use of pain medication as none (0), NSAID (1), oral narcotics as needed (2), oral narcotics scheduled (3) or parental narcotics (4), and mobility as ambulatory (1), ambulatory with assistance (2), wheelchair (3) or bedridden (4). The results of the procedures were classified as successful (no, minimal or mild residual pain), improved (decrease pain but more than mild residual pain) or failure (worse or no change in pain score).

Results:
Eight patients had multiple procedures. Seventy-two per cent (26/36) of the initial procedures were successful compared to 73% (11/15) for the subsequent procedures. Nineteen per cent (6/36) of the initial procedures showed improvement compared to 27% (4/15) of the subsequent procedures. There were three failures (8 %) among the initial procedures but none among the subsequent procedures. We saw no statistically significant differences between the two groups when the pain score, use of pain medication and mobility indices were compared. In the entire patient group the average.

Conclusions:
Patients who are successfully treated with vertebroplasty often return with a new fracture. Repeat vertebroplasty for the new fracture has the same prognosis as the initial procedure.