Treatment: Vertebroplasty: Outcomes

While incisional and muscular pain may persist for the first few days after the procedure, point tenderness that is noted before the procedure is not been noted in the majority of the patients after the procedure. Post-procedure, patients have a new baseline pain and mobility level after 3 weeks. Their use of narcotics for pain control is significantly reduced or eliminated.

• One study showed that 90 percent of patients (29 patients with 47 fractures) with age-related or steroid-induced osteoporosis experienced pain relief and improved mobility at 24 hours post-vertebroplasty. No worsening of pain post-procedure was reported.
• Another study showed significant pain reduction and improvement in health profile scores of 16 patients treated at 20 vertebral levels.
  • A third study described complete or partial pain relief in 97 percent of patients who were treated for painful metastasis (29 patients) and multiple myeloma (8 patients).
• A series of 289 vertebrae in 105 patients who were treated with percutaneous vertebroplasty for a variety of lesions showed favorable outcomes in 78 percent of patients with osteoporotic lesions, 83 percent of patients with malignant lesions, and 73 percent of patients with vertebral hemangiomas.
• Results of a study on percutaneous vertebroplasty in 231 patients showed a 90 percent success rate in the treatment of osteoporotic vertebral fractures and an 80 percent success rate in painful or unstable neoplastic lesions and vertebral hemangiomas.
• Another study reported good pain relief in 73 percent of patients with at least a 50 percent reduction in analgesic dose; this study also reported moderate pain relief in 29 percent of patients (37 patients, 52 vertebrae) with painful malignant vertebral lesions.
• A local tumoricidal effect within and around the cement mass has been demonstrated in a postmortem study of six patients who had been treated by vertebroplasty for malignant vertebral lesions.

Significant complications of the procedure are less than 1 percent, with a low morbidity rate. Less than 1% of patients with non-neoplastic lesions and only 5-8% of patients with neoplastic lesions have morbidity. Morbidity may include local pain, rib pain, spinal stenosis, nerve root compression, and intravascular extension of acrylic.

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