Voormolen M H J, Mali W P T M, Lohle P N M, Fransen H, Lampmann L E H, van der Graaf Y, Juttmann J R, Jansssens X, Verhaar H J J
Department of Radiology, St Elisabeth Ziekenhuis, Tilburg, The Netherlands.
AJNR Am J Neuroradiol. 2007 Mar;28(3):555-60.
To prospectively assess the short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures (VCF) treated with percutaneous vertebroplasty (PV) compared with optimal pain medication (OPM).
Randomization of patients in 2 groups: treatment by PV or OPM. After 2 weeks, patients from the OPM arm could change therapy to PV. Patients were evaluated 1 day and 2 weeks after treatment. Visual analog score (VAS) for pain and analgesic use were assessed before, and 1 day and 2 weeks after start of treatment. Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) and Roland-Morris Disability (RMD) questionnaire scores were assessed before and 2 weeks after start of treatment. Follow-up scores in patients requesting PV treatment after 2 weeks OPM treatment were compared with scores during their OPM period.
Eighteen patients treated with PV compared with 16 patients treated with OPM had significantly better VAS and used less analgesics 1 day after treatment. Two weeks after treatment, the mean VAS was less but not significantly different in patients treated with OPM, whereas these patients used significantly less analgesics and had better QUALEFFO and RMD scores. Scores in the PV arm were influenced by occurrence of new VCF in 2 patients. After 2 weeks OPM, 14 patients requested PV treatment. All scores, 1 day and 2 weeks after PV, were significantly better compared with scores during conservative treatment.
Pain relief and improvement of mobility, function, and stature after PV is immediate and significantly better in the short term compared with OPM treatment.
前瞻性评估经皮椎体成形术（PV）与最佳止痛药物（OPM）治疗亚急性或慢性疼痛性骨质疏松性椎体压缩骨折（VCF）患者的短期临床疗效。
将患者随机分为两组：接受PV治疗或OPM治疗。2周后，OPM组的患者可改为PV治疗。在治疗后1天和2周对患者进行评估。在治疗开始前、治疗开始后1天和2周评估疼痛视觉模拟评分（VAS）和止痛药物使用情况。在治疗开始前和治疗开始后2周评估欧洲骨质疏松基金会生活质量问卷（QUALEFFO）和罗兰-莫里斯残疾问卷（RMD）评分。将接受2周OPM治疗后要求PV治疗的患者的随访评分与其OPM治疗期间的评分进行比较。
18例接受PV治疗的患者与16例接受OPM治疗的患者相比，治疗后1天VAS明显更好，止痛药物使用更少。治疗后2周，OPM治疗的患者平均VAS更低，但差异无统计学意义，而这些患者止痛药物使用明显更少，QUALEFFO和RMD评分更好。PV组的评分受到2例新发生VCF患者的影响。在接受2周OPM治疗后，14例患者要求进行PV治疗。与保守治疗期间的评分相比，PV治疗后1天和2周的所有评分均明显更好。
与OPM治疗相比，PV治疗后疼痛缓解以及活动能力、功能和身高改善在短期内立即出现且明显更好。
