Clinical studyManagement of acute osteoporotic vertebral fractures: a nonrandomized trial comparing percutaneous vertebroplasty with conservative therapy
Section snippets
Patients and eligibility
All patients presenting to the emergency department (n = 37) of, or admitted as inpatients (n = 42) to, The Saint George Hospital from November 2000 to December 2001 with acute vertebral fracture syndrome were considered for the study. Inclusion criteria were acute severe vertebral fracture pain, densitometric evidence of osteoporosis, and acute fracture activity on magnetic resonance imaging or technetium-99m bone scan. Exclusion criteria were pathologic fracture due to myeloma/metastasis,
Results
The 24 men (30%) and 55 women (77%) in the study were followed for a mean of 215 days (range, 57 to 399 days), and they ranged from 51 to 93 years in age. Percutaneous vertebroplasty was performed in 55 patients (70%) on 71 vertebras, including 45 thoracic vertebras (T5 = 3, T6 = 2, T7 = 6, T8 = 11, T9 = 11, T10 = 2, T11 = 2, and T12 = 8) and 26 lumbar vertebras (L1 = 8, L2 = 6, L3 = 5, L4 = 3, and L5 = 4). One vertebra was injected in 42 patients, two vertebras in 11 patients, three vertebras
Discussion
Until recently, bed rest, narcotic analgesia, and physical support were the only treatments for acute vertebral compression fractures, and these had limited efficacy (21). Percutaneous vertebroplasty, which was designed for treating aggressive angiomas, bone metastases, and myeloma 8, 22, has been used increasingly for the management of acute osteoporotic vertebral fractures 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14. However, previous studies have been short in duration and have not had a
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Dr. Clark is employed as an interventional radiologist by Mayne Health Diagnostics, Saint George Private Hospital, Sydney, Australia.