What are the predictors of scientific success after percutaneous vertebroplasty for osteoporotic vertebral fractures?
Eur Radiol. 2018 Feb 09;:
Authors: Denoix E, Viry F, Ostertag A, Parlier-Cuau C, Laredo JD, Cohen-Solal M, Bousson V, Funck-Brentano T
Summary
OBJECTIVES: Osteoporotic vertebral fractures are answerable for acute ache and incapacity which will persist for greater than 2 months. We wished to establish predicting components for mid-term consequence after vertebroplasty.
METHODS: We included consecutive sufferers who underwent vertebroplasty for fragility fractures with persistent and intense ache between January 2014-June 2016. Final result was assessed by an unbiased clinician after 1 month utilizing a standardized questionnaire. Sufferers had been categorized as having both a positive or a poor consequence. Presence of an intravertebral cleft and bone oedema imply sign depth was assessed by an unbiased radiologist blinded to the scientific information. Pre-intervention scientific or radiological components had been analysed as predictors for consequence.
RESULTS: Within the 78 included sufferers (females 71%, age 75 ± eight.three years), 61.5% had a beneficial consequence. When vertebroplasty was carried out inside 2 months after fracture, the result was beneficial in 19 sufferers (39.6%) and poor in 5 (16.7%; estimate for beneficial consequence: OR?=?four.1, 95% CI 1.2-13.eight, p?=?zero.021). Absence of intravertebral cleft on pre-intervention imaging was additionally a predictor of beneficial consequence (OR?=?three.7, 95% CI 1.2-11.eight, p?=?zero.024). On pre-intervention MRI, vertebral physique oedema depth sign didn’t affect the result.
CONCLUSIONS: In sufferers with persistent and intense ache after an osteoporotic vertebral fracture, early intervention and absence of intravertebral cleft had been predictors of beneficial consequence at 1 month after vertebroplasty.
KEY POINTS: • Performing vertebroplasty inside 2 months following a fragility fracture will increase success price. • Presence of an intravertebral cleft at baseline is a predictor of poor mid-term consequence. • A pre-intervention MRI must be carried out to determine the indication of vertebroplasty.
PMID: 29426990 [PubMed – as supplied by publisher]