The role of imaging studies of percutaneous vertebroplasty in 63 patients with osteoporotic compression fracture: Preliminary report

To evaluate the role of imaging studies for percutaneous vertebroplasty to treat back pain associated with osteoporotic compression fractures for the vertebral bodies. Sixty-three patients (51 women, 12 men; mean age, 70.6 y/o) suffering from back pain refractory to medical treatment received percutaneous injections of polymethylmethacrylate (PMMA) into 66 vertebrae (32 thoracic and 34 lumbar) under biplane fluoroscopic guidance. Plain radiograph, computed tomography, and/or magnetic resonance imaging were performed for pre-operation survey. During the procedure, intraosseous venography was performed before PMMA injection. After the procedure, plain radiograph and CT of each treated vertebral level were obtained immediately to evaluate the migration of PMMA. At follow-up 3 months after vertebroplasty, patients were asked to complete a questionnaire. The procedures were technically successful in all patients. After treatment, fifty-four (86%) patients reported improvement in back pain from compression fractures. Fifty-four (86%) patients reported satisfaction with percutaneous vertebroplasty. The single serious adverse event involved clinically was suspected pulmonary embolism syndrome. The complication rate was 1.6 percent. In multiple compression fractures, pre-operative MRI evaluation is very helpful for determining appropriate treatment. Percutaneous vertebroplasty is a minimally invasive procedure which can provide satisfactory symptomatic relief for patients with refractory back pain associated with osteoporotic compression fracture. All kinds of imaging studies play their own roles in the procedure.