Percutaneous vertebroplasty for elderly patients with unhealed osteoporotic spinal fractures

Background:   Vertebroplasty is a procedure in which bone cement is injected percutaneously into the vertebral body.
Methods:   We used this technique with 15 patients who had pseudarthrosis or delayed union of osteoporotic spinal fractures with vacuum clefts, and in whom conservative treatment did not relieve persistent pain. The procedure was performed in a short time with little blood loss, and no generic complications, leakage of bone cement to blood vessels or the spinal canal, or neural compression.
Results:   At 1 week after the operation, pain was eliminated in seven patients, alleviated in seven patients, unchanged in one patient, and worsened in none. The rate of alleviation or elimination of pain after 1 week and 6 months was 93% and 85%, respectively. Recurrence of the pain was seen in four cases, but this was caused by new spinal fractures in separate locations, confirmed with magnetic resonance imaging, in three patients, and by multiple myeloma in one patient.
Conclusion:   Thus, vertebroplasty, which alleviates pain rapidly and with low invasiveness, is a new and promising therapy for osteoporotic spinal fractures in which conservative treatment has failed. It seems to provide a large benefit to elderly patients if performed with prudent care with regard to complications at the time of bone cement injection, and in conjunction with treatment for osteoporosis.