Novel vertebral compression fracture surgery shows promise
MedWire News: Study findings demonstrate the efficacy of a novel treatment for symptomatic vertebral compression fractures (VCFs) in patients with osteoporosis.
The procedure avoids the risk of cement leakage into the vertebral body, a complication that may occur in osteoporotic patients who undergo vertebroplasty and kyphoplasty procedures for VCFs.
Vesselplasty overcomes this issue by placing a polyethylene terephthalate (PET) balloon with porous fibers into the vertebra, and expanding the balloon by injection of cement. A small amount of bone cement can pass through the balloon and fix it to the vertebra.
“Vesselplasty is a safe alternative in the treatment of VCFs,” said lead author Lucia Flors (Hospital Universitario Doctor Peset, Valencia, Spain).
“It is an image-guided procedure that only requires conscious sedations and local anesthesia. Most patients [report] improvement in their level of pain immediately following the procedure.”
The team describes the outcome of 37 vesselplasty procedures performed in 29 patients between 2006 and 2008 for painful VCFs caused by osteoporosis (73%), trauma (13.5%), or malignancy (13.4%).
Patients reported an average pre-operative pain score of 8.72 on a 10-point visual analog scale where 0 is no pain and 10 the worst possible pain, and this fell significantly to 3.38 points at 3 months after surgery.
In addition, patients experienced an improvement in mobility, from being able to walk with assistance only for short distances to being able to walk with or without assistance.
Before surgery patients had an analgesic score of 3.07 denoting using of oral narcotics as required and this fell after surgery to 1.86 representing use of non-narcotic prescription drugs or nonsteroidal anti-inflammatory agents.
However, patients with malignant VCFs did not experience benefits in analgesia and mobility, and had only a small improvement in pain after the procedure.
Writing in the American Journal of Roentology, the team says that just one technical difficulty occurred involving a small leak but that no patient experienced complications from the procedure.
Flors et al conclude: “Our study results indicate the need for a prospective, treatment-randomized, controlled study with a larger number of patients and long-term follow-up.”
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By Lynda Williams