Improved pain and quality of life outcomes after percutaneous vertebroplasty for thoraco-lumbar non-osteoprotic compression fractures

Abstract

Introduction: Vertebroplasty is a minimally invasive technique in which percutaneous injection of bone cement under fluoroscopic guidance Percutaneous vertebroplasty (PVP) has been widely and successfully accepted in the treatment of osteoporotic and neoplastic vertebral compression fractures to control pain refractory to medical treatment. However, using of vertebroplasty as primary line treatment for traumatic, non-osteoporotic compression fractures still not widely accepted and considered a debatable issue.

Patients and methods: This prospective comparative study was conducted at Neurosurgery department, Mansoura university hospital and Mansoura emergency hospital through the period between January 2015 and March 2016. 20 patients complaining of back pain due to single level thoracolumbar vertebral compression non-osteoprotic fractures were admitted to the study. Patients were divided into two groups 10 patients each, PVP group and conservative group. Outcome were assessed as regard pain improvement using Visual analogue scale VAS and quality of life using short form 36 scale (SF36).

Results: Ten patients in the PVP group received Vertebroplasty, eight males (80%) and two females (20%) the age ranged from 29 to 62 years with mean age of 44.2+8.3 (mean+SD) years. The conservative group included ten patients seven males (70%) and three females (30%) the age ranged from 31 to 64 years with mean age of 45.1+9.2 (mean+SD) years. The level of injury ranged from D6 to L4. VAS and SF36 results showed significant improvement in post injection results compared to preinjection and to the conservative group

Conclusion: Percutaneous vertebroplasty is safe and effective procedure to improve pain and quality of life in non osteoprotic patients complaining of traumatic compression fractures of thoraco-lumar region it decreases pain, and provide early ambulation of patients which improve their quality of life without significant morbidity.