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Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 95

Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 95. Spinal disorders are among the most common medical conditions with significant impact on health related quality of life, use of health care resources and socio-economic costs. Spinal surgery is still one of the fastest growing areas in clinical medicine. | Osteoporotic Spine Fractures Chapter 32 939 Table 12. Results of vertebroplasty Reference Patient number Levels treated Duration of FU Pain improved Complications remarks Prospective case series McKiernan 65 46 66 6 months none Zoarski 105 30 54 15-18months 96 none 2 local leaks not symptomatic Perez-Higueras 77 13 27 60 months 12 13 2 transitory neuritis local leakage 48 3 adjacent fractures McGraw 64 100 156 21 months 93 1 sternal fracture 1 transient neuritis Heini 37 17 45 12 months 76 none local leakage in 20 clinically insignificant Cortet 17 16 20 6 months no complications McKiernan 66 41 65 2 weeks dynamic fracture mobility present in 44 of patients Retrospective case series Barr 4 39 70 18 months 2-42 95 1 transient neuritis Hodler 38 152 363 8.8 months 86 71 local leakage without clinical 1 -24 sequelae Jensen 41 29 47 - 90 Brown 9 41 77 15.8 months 6-28 80 fractures older than 12 months Maynard 63 27 35 - 93 patients with positive bone scan Cyteval 18 20 nm - 75 one leakage into psoas one adjacent level fracture Kaufmann 48 75 122 7 days - preprocedural pain medication and activity level predictive for outcome Peh 76 37 48 11 months 3-24 97 43 leakage without clinical symptoms lapse 37 . Even in older fractures VP can still be effective 9 . In patients with severe osteoporosis and rapidly developing fractures the reinforcement of multiple levels is an efficient means to preserve posture and prevent further collapse Fig. 4 36 . A non-union after a VBCF can occur in up to 40 of patients 66 . In these situations cementing of the defect provides stability Fig. 6 . The treatment of osteoporotic VBCF by percutaneous cement injection has become a well established treatment option. Several prospective case series have been published and confirm a rapid and lasting pain relief in 80 - 90 of patients Table 11 4 23 36-38 77 . In fresh fractures the pain improvement is seen in 93 of patients 63 . But also in older lesions the treatment can be effective in as many as