Background Management options for patients with persistent back pain after a vertebral fracture include vertebral augmentation, but its use is controversial.
Objectives Our iam was to evaluate the fracture cause, efficacy and complications of consecutive vertebroplasties performed in our Hospital in a 12 years period.
Methods Retrospective study of vertebroplasties performed at a University Hospital in the last 12 years (April 2004 to April 2016). The duration of follow-up was more than 12 months. Epidemiological variables, indications, time elapsed, efficacy and complications of the procedure were collected. The indication of vertebroplasties in fractures was pain refractory to usual symptomatic treatment in these pathologies: osteoporosis, trauma, leukemia/lymphoma, metastasis and hemangioma. Efficacy was assessed at 6 and 12 months with a simple verbal scale according to the pain response (improvement/non-improvement). Patients who died before 12 months period were excluded for the that parameter. A comparative study of the efficacy between a)cause of fracture, b)location, c)time elapsed, d)access route and e)complication was performed. For the descriptive analysis we used frequencies and percentages in the case of qualitative variables, and mean and standard deviation (SD) or median and interquartile range for quantitative variables. Chi-square test or Fisher's exact test was used in for qualitative variables, and Wilcoxon's non-parametric test for evolution time. Statistic analysis was performed with the SAS System for Windows V 9.2.
Results 66 vertebroplasties were performed in 44 patients (75% female/25% male). Their mean age was 70.63±10.60 years (range, 46–96 years). The description of the causes of fracture, its level, the access route and the cement leaks are expressed in TABLE. The median time from fracture to vertebroplasty was 3 months [1–6]. 78% of the fractures were osteoporotic and had a better response to pain at 6 months than all other fractures (p<0.05), although at 12 months there were no differences (p=0.42). Only 12.5% had refracture. Pain control and vertebral refracture did not differ between neither the access rout nor the cement leakage and its magnitude. In the 12-month follow-up, 7 patients died (6 due to neoplasia, 1 due to sudden death) and no case was related to vertebroplasty.
Conclusions In our experience vertebroplasty has been shown to be an effective technique for the control of refractory pain in vertebral fractures regardless of cause and time of evolution. Likewise, only 12.5% presented refracture in the following 12 months to the procedure. According to our study we can consider vertebroplasty as an effective and safe alternative in this type of patients.
Disclosure of Interest None declared