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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2005, Number 4

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Acta Ortop Mex 2005; 19 (4)

Vertebroplasty: Treatment of pain for osteoporotic vertebral compression fractures

Cervín SS, Irineo CAB, Flores FP, Osuna RI

Language: Spanish
References: 88
Page: 143-151
PDF size: 83.15 Kb.


ABSTRACT

Osteoporotic vertebral compression fractures (VCS) affect 700,000 patients per year in the United States. They had includes an annual cost of 10 billions, alone 260,000 are painful and refractory to medical therapy. The operative stabilization is rarely employed because of its significant rate of morbidity and high likelihood of instrumentation failure. Vertebroplasty and calcitonin are procedures for the treatment of intense pain caused by vertebral compression fractures. Objective. To evaluate the safety and efficiency of vertebroplasty versus calcitonin, in the treatment of painful osteoporotic vertebral compression fractures. Design. Controlled clinical trial. Material and methods. Between september 2002 and January 2004, in our institution 60 patients were randomly assigned to receive either 100 UI of calcitonin or percutaneous vertebroplasty. All had severe back pain for more than three months which did not respond to conservative treatment. Pain evaluation was performed daily using a visual analogue (VAS). Safety was determined for complications of the treatments. The pain relief, morbidity and mortality were measurements 1, 30, 60 and 90 days. Success was defined percentage reduction of pain intensity ≥ 80%. It was considered statistically significant p ‹ 0.05. Intention-to-treat analysis and statistical model GEE was performed. Results. A total of 60 patients (54 female and 6 male), the mean age was 75.5 years (range, 55-92 yr). The duration of follow-up was 3 months. Complete assess ments were performed in all patients. Both groups they had pain intensity, of EVA 8 ( P5 = 8 y P95 = 9). In the vertebroplasty (n = 30) group , compared with calcitonin (n = 30). Significant postprocedural improvement in the vertebroplasty group was demonstrated versus calcitonin group at 90 days (p ‹ 0.05 pain and mobility). The adverse effects were similar for the both groups 6.6%. Conclusion. The vertebroplasty provided significant relief in a high percentaje of patients with painful osteoporotic compression fractures. Is a safe and feasible than calcitonin.


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