Voormolen Maurits H J, Lohle Paul N, Lampmann Leo E, van den Wildenberg Wilco, Juttmann Job R, Diekerhof Carel H, de Waal Malefijt Jan
Department of Radiology, St Elisabeth Ziekenhuis, P.O. Box 90151, 5000 LC Tilburg, The Netherlands.
J Vasc Interv Radiol. 2006 Aug;17(8):1313-20. doi: 10.1097/01.RVI.0000231952.75209.4A.
To prospectively assess short-term, midterm, and long-term pain relief in patients with painful osteoporotic vertebral compression fractures (VCFs) treated with percutaneous vertebroplasty (PV).
Visual analog scale (VAS) scores for pain at the treated vertebral level, analgesic use, and satisfaction with outcome were assessed in 112 patients after PV of 168 VCFs. Serial follow-up was performed at 24 hours and 3, 6, and 12 months and in a small number of patients at 1-3 years. Procedure-related complications were evaluated by physical examination and computed tomography of treated levels.
After PV, VAS scores for pain at the individual vertebral levels treated and use of analgesic agents were significantly reduced compared with before treatment at every follow-up period. Within 24 hours after the procedure, the decreases in all scores were less compared with scores at later follow-up periods, but this was not significant. The preprocedural mean VAS score was 8.8 (range, 5-10). At follow-up, mean VAS scores ranged from 2.5 to 3.3 (range, 0-10). In the short term after PV, patients used significantly less analgesic drugs and 86% of patients were satisfied with the outcome. At midterm and long-term follow-up, patients used even less analgesic drugs and 95%-100% of patients were satisfied with the outcome of PV. Procedure-related complications with clinical consequences occurred in three patients (2.7%): one patient experienced a cardiovascular reaction, one patient had a pedicle chip fracture, and one had a rib fracture.
PV of painful osteoporotic VCFs provides significant pain reduction in nearly all treated patients.
前瞻性评估经皮椎体成形术（PV）治疗疼痛性骨质疏松性椎体压缩骨折（VCF）患者的短期、中期和长期疼痛缓解情况。
对112例接受168处VCF的PV治疗的患者，评估治疗椎体节段的疼痛视觉模拟量表（VAS）评分、镇痛药使用情况及对治疗结果的满意度。在术后24小时、3个月、6个月和12个月进行系列随访，少数患者随访1至3年。通过体格检查和治疗节段的计算机断层扫描评估与手术相关的并发症。
PV术后，在每个随访期，与治疗前相比，治疗的各个椎体节段的疼痛VAS评分和镇痛药使用量均显著降低。术后24小时内，所有评分的降低幅度均小于后期随访期，但差异无统计学意义。术前平均VAS评分为8 .8（范围5 - 10）。随访时，平均VAS评分范围为2.5至3.3（范围0 - 10）。PV术后短期内，患者使用的镇痛药显著减少，86%的患者对治疗结果满意。在中期和长期随访中，患者使用的镇痛药更少，95% - 100%的患者对PV治疗结果满意。发生了3例（2.7%）有临床后果的与手术相关的并发症：1例患者出现心血管反应，1例患者发生椎弓根碎片骨折，1例患者发生肋骨骨折。
疼痛性骨质疏松性VCF的PV治疗能使几乎所有接受治疗的患者疼痛显著减轻。
