Percutaneous vertebroplasty for compression fractures in our own population: Observations recommendations and a outcome grading system
|IJOCP | Volume – 2015| Issue – 2015| Article ID – 2015:63
Conference: Indian Orthopaedic Association Annual Conference IOACON-2013, India [Click for Full details]
Authors: Karmakar A
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Osteoporotic vertebral compression fractures are a leading cause of disability and morbidity in the elderly. vertebral compression fractures occur in 20% of people over the age of seventy years and in 16% of postmenopausal women. We evaluated the outcome of percutaneous vertebroplasty with bone cement in osteoporotic vertebral compression fractures in our population with a outcome grading system developed by us and generated recommendations and techniques to maximise the benefit of the procedure. 25 patients (30 fractured vertebras) of osteoporotic vertebral compression fractures without any neurological deficit were included in the analysis. All patients were treated with percutaneous vertebroplasty with radiopaque bone cement (opacity+).
The patients were clinically evaluated for neurological signs, the Oswestry Disability Questionnaire(ODQ), Visual Analogue Scale(VAS) were recorded at presentation, immediate post op, 1 week after post op, 3 months after, then 6 monthly. The average follow up period was 13.8 months (6-18 months). Of these 30 fractured segments 14 were of D12 (46.66%), 6 each were for D11 & L1 (20% each) and 4 were L2 (13.34). We operated 14 patients (56%) within 2-4 weeks after the fracture. The average interval between fracture and procedure was 3.72 weeks. Among the 4 patients operated within 2 weeks both of them had radiological cement leakage with fair results. In our series in 63.4% cases 3 cc cement was injected per segment, average being 2.9 cc. Most of the patients (56%) reported significant pain relief within 10 minutes of the procedure. We didn’t face any major complication. The ODQ sore shows 44.73% reduction in 1 month and 45.9% reduction at 6 months follow-up. The VAS score shows 49.02% reduction at 1 month and 74.2% reduction at 6 months. We graded our results and outcomes in good, fair and poor category depending on various criteria, of which 76% comes under good and rest 24% in fair category, no poor result found.
The percutaneous vertebroplasty with bone cement is still a justified treatment procedure for osteoporotic vertebral compression fractures as it provides excellent pain relief, internal stability to the fractured vertebra thus preventing further collapse & progression of kyphosis, allowing the patients to regain normal activity at the earliest, at a very reasonable cost, with avoidable side effects as it is far better than other conservative methods of management.
|How to Cite this Abstract|
|Karmakar A . Percutaneous vertebroplasty for compression fractures in our own population: Observations recommendations and a outcome grading system. International Journal of Conference Proceedings 2015;(2015):65|