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Symptomatic Improvement After Vertebroplasty for Acute 2004

Do, Huy, M.D., Massengale, Justin, M.D., Marcellus, Mary, M.D., Lim, Michael, M.D., Lane, Barton, M.D.

Purpose:
Percutaneous vertebroplasty with polymethylmethacrylate was performed on 4 patients ranging in age from 22 to 55 years involved in motor vehicle, sports, or blunt trauma. Lesions treated included acute traumatic vertebral body compression fractures at T8, T9, L1 and L4, with 10% to 30% loss of vertebral body height and less than 20% canal retropulsion. Indications for procedure in al l cases included persistent or worsening pain refractory to medical management, and progressive worsening compression in 1 case. Visual analog scores, mobility scales and medication use scales were used to assess all patients before vertebroplasty and at 6 weeks.

Methods:
Percutaneous vertebroplasty with polymethylmethacrylate was performed on 4 patients ranging in age from 22 to 55 years involved in motor vehicle, sports, or blunt trauma. Lesions treated included acute traumatic vertebral body compression
fractures at T8, T9, L1 and L4, with 10% to 30% loss of vertebral body height and less than 20% canal retropulsion. Indications for procedure in al l cases included persistent or worsening pain refractory to medical management, and progressive worsening compression in 1 case. Visual analog scores, mobility scales and medication use scales were used to assess all patients before vertebroplasty and at 6 weeks.

Results:
Vertebroplasty of acute vertebral body compression fracture reduced visual analog pain scores, initially noted as 8 or greater in all patients, to 0 or 1 at 6 weeks. Mobility, ranging on presentation from mildly impaired to wheelchair dependent, had improved in all patients studied after 6 weeks with restored ability to perorm daily activities. Analgesic requirements, including NSAIDS and narcotic agents on schedule as well as on demand, had disappeared after 6 weeks post-procedure in all patients, with only one patient requiring prescription non-narcotic pain medication. All patients had stable neurological examinations at follow-up.

Conclusions:
Preliminary results indicate that percutaneous vertebroplasty can effectively improve pain score, mobility and analgesic dependence when used to treat acute vertebral body traumatic compression fractures.