Prospective Assessment of Pain and Functional Status After Percutaneous Vertebral Body-Perforation Procedure for Treatment of Vertebral Compression Fractures

• Published in: Neurologia medico-chirurgica Vol. 53; no. 2; pp. 71 - 76
• Main Authors: YAMADA, Makoto, YOKOYAMA, Kunio, KAWANISHI, Masahiro, TANAKA, Hidekazu, ITO, Yutaka, HIRANO, Masashi, KUROIWA, Toshihiko
• Format: Journal Article
• Language: English
• Published: Japan The Japan Neurosurgical Society 2013; THE JAPAN NEUROSURGICAL SOCIETY
• Subjects: Activities of Daily Living - classification; Aged; Aged, 80 and over; Female; Fractures, Compression - surgery; Humans; intravertebral pressure; Lumbar Vertebrae - injuries; Lumbar Vertebrae - surgery; Magnetic Resonance Imaging; Male; osteoporosis; Pain Measurement; Pain, Postoperative - classification; Pain, Postoperative - diagnosis; Prospective Studies; Punctures; Spinal Fractures - surgery; Surgery, Computer-Assisted; vertebral body perforation; vertebral compression fracture; Vertebroplasty; Walking
• ISSN: 0470-8105; 1349-8029
• DOI: 10.2176/nmc.53.71

Percutaneous vertebral body perforation is a new technique for treating painful vertebral compression fractures (VCFs). We prospectively evaluated this treatment in 45 consecutive patients with 63 VCFs treated at our hospital between September and December 2009. In all patients, long-term conservative treatment had failed to achieve pain relief, resulting in reduced changes in activities of daily living (ADL). We evaluated visual analogue scale (VAS) scores for pain before and after vertebral body perforation as well as in the chronic phase, changes in ADL, whether recipients would recommend this treatment, and complications. The mean VAS score improved from 6.9 ± 1.9 before surgery to 3.6 ± 2.9 immediately after surgery, and to 2.5 ± 2.1 at 3 months. ADL was improved in 27 patients, and walking became possible in 16 of 24 patients who had been unable to walk. Nearly two-thirds of patients would strongly recommend this treatment to others. The analgesic effect of vertebral body perforation was significantly lower in patients with than in those without vertebral pseudarthrosis before surgery. Only 1 patient suffered a new fracture during the 3-month period after surgery, but there were no perioperative complications. Vertebral body perforation for painful VCFs can achieve early improvement of ADL due to the analgesic effect in carefully selected patients and is a safe treatment with a low frequency of complications.