Percutaneous vertebroplasty in osteoporotic vertebral compression fractures: our initial experience.

OBJECTIVE To see the safety and efficacy of Percutaneous vertebroplasty in osteoporotic vertebral compression fractures. METHODS This study was conducted at the Department of Neurosurgery, Liaquat National Hospital (LNH) Karachi, Pakistan. Patients with osteoporotic compression vertebral fractures, not responding to conservative treatment and having localized overlying tenderness and MRI evidence of high signal in the involved vertebral body, were included in the study. Visual Analogue Scale was used to measure the intensity of pain. Percutaneous vertebroplasty (PVP) was performed by injecting polymethylacrylate in the diseased vertebral body. The patients were followed up for initially 4 and 24 hours. Later they had a check up at 2 weeks, one three, six and twelve months. RESULTS Percutaneous vertebroplasty on twentyfour patients were included who underwent (LNH) from 2002 to 2006 Age range was from 65 to 85 years (mean age 75 +/- 3.3 years). Among 24 patients, 21 were females and 3 patients were male. Six patients had two levels osteoporotic compression vertebral fractures the rest, had compression at one level. Patients with radicular pain or signs of myelopathy, osteomyelitis of targeted vertebral body or overlying skin infection, severe compression of vertebral body or with retropulsed fragment into canal as evident by CT scan were excluded from the study. While patients who failed to respond to 6-12 weeks of conservative treatment, with localized overlying tenderness and MRI evident high signal in vertebral body involved, were included in the study. Visual analogue scale (VAS) was applied for the assessment of pain intensity. Followup was performed immediately, within 4 hours, after 24 hours, 2 weeks, 1 month, 3 months, 6 months and finally at one year. CONCLUSION Percutaneous vertebroplasty is a safe and useful procedure for the treatment of backache associated with osteoporotic vertebral compression fracture.