Vertebroplasty Provides Significant and Sustained Pain Relief

A new study shows that vertebroplasty provides dramatic and lasting pain relief for vertebral compression fractures (VCFs).

Researcher at San Giovanni di Dio Hospital (Cagliari, Italy) and five other Italian centers participating in the European Vertebroplasty Research Team (EVEREST) retrospectively evaluated the clinical outcomes of vertebroplasty in 3,211 women and 1,336 men who were treated for severe painful osteoporosis and painful vertebral tumors--metastases or myeloma--with high risk of fracture and symptomatic vertebral angioma. Inclusion criteria were VCF with bone edema, local back pain with single-point pressure on examination, and poor or no response to medical therapy. The average number of VCFs treated with vertebroplasty in the same patient was 3, for a total of 13,437 fractures; the patients were evaluated at baseline and through a one-year follow-up for pain relief using an 11-point visual analog scale (VAS). Evaluation at each follow-up point included pain response using VAS, physical examination, and X-rays at 48 hours and one month, with physical examination at three months and one year.

The results showed that within 48 hours, 4,004 of the 4,547 patients (88.06%) experienced clinically significant pain relief, with an average VAS score of 2 and an average difference from baseline of 5.5 to 6. The pain remained improved at each follow-up evaluation period up to 12 months. The results remained consistent in osteoporotic patients, patients with metastases, myeloma patients, patients with hemangioma, and trauma patients. No major neurologic complications were encountered; venous leakage was the most frequent mild one, present in 20.5% of the patients. According to the authors, of the 4,547 patients treated, only 430 (13%) were retreated for a subsequent fracture, and in 302 of those 430 patients (70.2%), the new fracture occurred in the contiguous vertebra. The study results were presented at the American Society of Spine Radiology annual symposium, held during February 2010 in Las Vegas (NV, USA).

"Vertebroplasty is shown to provide sustained pain relief for osteoporotic vertebral fractures. Osteoporosis, metastases, and myeloma patients remain susceptible to new fractures, which often occur in the vertebra next to an existing fracture,” said lead author and study presenter interventional radiologist Stefano Marcia, M.D., of San Giovanni di Dio Hospital. "Our large-scale study shows that vertebroplasty does not increase the risk of fracture in the level adjacent to previously treated vertebra and that these new fractures occur at the same rate as they would in patients who did not have vertebroplasty.”

Related Links:
San Giovanni di Dio Hospital