Clinical evaluation of vertebroplasty for multiple-level osteoporotic spinal compression fracture in the elderly

Introduction: Outstanding results have been achieved using vertebroplasty for the treatment of osteoporotic spinal compression fractures. However, few reports are available in the management of multiple-level compression fractures due to severe osteoporosis. This study prospectively evaluated the clinical and surgical outcomes of patients receiving vertebroplasty due to multiple-level osteoporotic spinal compression fractures. Patients and methods: Eighteen patients underwent more than four levels of vertebroplasty due to multiple-level osteoporotic spinal compression fracture. All patients received a preoperative magnetic resonance imaging (MRI) check-up to determine which level needed vertebroplasty. Detailed evaluations were made in accordance with the patients' clinical tracking, pre- and postoperative daily activities, Denis pain scale, and Roland-Morris score. Results: After an average follow-up period of 36 months, the group receiving multiple-level vertebroplasty showed significant improvement, as registered on the Denis pain scale, Roland-Morris score, and in the activity of daily living. No major complications occurred during operation or postoperation, except one patient who expired due to suffocation at the rehabilitation center 3 weeks after vertebroplasty. Conclusions: The use of vertebroplasty with cement to treat multiple-level osteoporotic spinal compression fractures in the elderly does have value, and brings good results to patients which were previously unimaginable. Preoperative MRI to evaluate the non-union levels and determine which levels needed vertebroplasty is very important.