Vertebroplasty for a New Fracture Has the Same Prognosis as the Initial procedure

Mayumi Oka, MD Yuji Numaguchi, MD, PhD Per-Lennart Westesson, MD, PhD, DDS

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Background

•! Approximately 80% success rate. •! Many patients return with new

fractures after the procedure.

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Study purpose

•! Assess outcome of subsequent

vertebroplasties for new fractures in patients

who were treated with vertebroplasty.

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Patients

•! 18 females •! 18 males •! Mean age 75 years (46 to 93 years) •! Initial procedures 36 (63 levels) •! Subsequent procedures 15 (21 levels)

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Etiology of vertebral fractures

•! Osteoporosis 29 patients

•! Metastasis 5 patients

•! Multiple myeloma 2 patients

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Evaluations

•! Pain 0 (no pain) 6 (extreme)

•! Medication 0 (no meds) 4 (IV narcotics)

•! Mobility 1 (ambulatory) 4 (bedridden)

Adopted from O�Brien et al. AJNR 2000; 21:1555-58

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Outcome assessment

•! Successful No to mild residual pain •! Improved Decreased pain

•! Failure No change or worse

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68 y.o. male with COPD on steroids

Post op CT

T4

T5

L5

L3

T1W post Gd

T4 T5

L3

L3

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2 months after first procedure

L1 T12

T1W post Gd Post op CT Presentation material for educational purposes only. All rights reserved. ©2002 URMC Radiology Page 9 of 13

After 4 procedures

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Results

Outcome Initial N=36

Subsequent N=15

Successful 72 % 73 %

Improved 19 % 27 %

Failure 8 % 0 %

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Pre vs. Post

Pain Medication Mobility Initial 4.9 ! 1.6* 2.7 ! 1.3* 2.6 ! 1.8* Procedure Subsequent 4.3 ! 1.3* 2.7 ! 1.1* 1.9 ! 1.1* Procedure

Wilcoxon rank sum test: p<0.05

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Conclusion

Vertebroplasty for a new fracture has

the same prognosis as the initial

procedure

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