Analysis Of The Effects Of Percutaneous Vertebroplasty In Osteoporotic Compression Fractures

摘要

Percutaneous vertebroplasty in the treatment of symptomatic vertebral compression fractures has become a popular treatment modality. The main purpose of the procedure is pain relief. Recent studies however, have cast doubt on its efficacy. An additional benefit of the procedure is possibly a partial restoration of the height of the collapsed vertebral body with potential improvement in the sagittal alignment and biomechanics of the spine. Digital radiographs of 70 thoracolumbar osteoporotic compression fractures in 57 patients were reviewed retrospectively before and after vertebroplasty for changes in the vertebral height, wedge angle, kyphosis angle, thoracolumbar and lumbar sagittal angles. Increases in anterior and middle heights post-vertebroplasty were statistically significant, along with improvements in the wedge angle and thoracolumbar sagittal alignment. This study shows that percutaneous vertebroplasty effectively increases vertebral body heights resulting in improvements in the wedge angles. These improvements are achieved solely by placing patient in the prone position during the procedure. In addition, there was improvement in the thoracolumbar sagittal alignment. This finding is previously unreported and although the significance of this improvement is unclear, it may potentially result in improved biomechanics of the spine which may in turn result in reduced risk of adjacent level vertebral fractures.