What are the reported outcomes of percutaneous vertebroplasty and kyphoplasty?

Updated: Jul 29, 2020
  • Author: Jeffrey P Kochan, MD; Chief Editor: Felix S Chew, MD, MBA, MEd  more...
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Answer

Answer

Approximately 85-90% of patients have rapid pain relief.

This procedure is associated with a low morbidity rate. Less than 1% of patients with nonneoplastic 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.

At the author's institution, pain improved in all patients who have undergone vertebroplasty; approximately 90% of patients note a complete resolution of pain. Incisional and muscular pain may persist for the first few days after the procedure. Point tenderness that is noted before the procedure has not been noted in any of the patients after the procedure. Follow-up assessment is made by telephone. The patient completes a questionnaire before the procedure and 3 weeks and 6 months after the procedure for comparison. Preliminary survey results suggest that patients have a new baseline pain and mobility level at 3 weeks after the procedure, and their use of narcotics for pain control is significantly reduced or eliminated. Anecdotal evidence suggests that vertebroplasty of metastatic spinal lesions may also retard the growth of the tumor and reduce and stabilize pain. [13]

Although pain is reduced or eliminated after the procedure, patients must exercise caution in subsequent activities because other osteoporotic vertebral bodies may also be prone to fracture. Medical management of the underlying disorder that weakens the vertebral bodies should be initiated. This procedure does not eliminate the need for aggressive treatment of osteoporosis, without which other fractures may ensue. Ideally, treatment should include Actonel; Fosamax; Miacalcin; calcium supplements; and multivitamins, including vitamins C and D. Hormonal replacement therapy should also be considered in female patients. Alterations in the medications and dosage of drugs that predispose the patients to osteoporosis (eg, steroids) should also be evaluated. Progress should be monitored with serial dual-energy x-ray absorptiometric (DEXA) scans. For complete medical treatment details, see Medscape Reference article Osteoporosis.


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