Literature DB >> 19465306

Predictors of successful palliation of compression fractures with vertebral augmentation: single-center experience of 525 cases.

Ruchira M Jha1, Albert J Yoo, Ariel E Hirsch, Marion Growney, Joshua A Hirsch.   

Abstract

PURPOSE: To determine the effectiveness of vertebral augmentation in relieving pain, differences in pain relief outcomes based on procedure type were investigated. Variables that potentially influence outcomes were identified.
MATERIALS AND METHODS: A database of 525 cases (740 levels) treated for compression fractures with vertebroplasty, kyphoplasty, or S1-level sacroplasty was compiled. Average age was 75 years +/- 12, and 72.4% of patients were female. Variables evaluated included age, sex, fracture etiology, procedure type, vertebral level treated, number of levels treated per procedure, and technical approach. Outcomes were assessed by a binary system of "responders" (ie, patients with improvement/resolution of pain) versus "non-responders" (ie, those with no change/worsening of pain) and with a four-level pain scale (1, pain resolution; 2, pain improvement; 3, no change; 4, worse pain) retrospectively applied from medical records. Univariate and multivariate analyses determined outcomes.
RESULTS: Four-hundred and sixty-seven patients (89%) showed a response to treatment: 40% had pain resolution and 49% had pain improvement. Multivariate analysis showed that women and older patients had greater odds of being responders (odds ratios [ORs], 0.56 and 0.98, respectively; P = .016 and P = .048, respectively). Patients without cancer (OR, 1.60; P = .012) and women (OR, 2.05; P = .0002) were more likely to experience pain resolution. Increasing numbers of levels treated per case were associated with decreased odds of pain resolution (OR, 0.69; P = .0081). Sex and number of levels treated were independently predictive of pain scale outcomes (ORs, 2.0 and 0.71, respectively; P = .0003 and P = .015).
CONCLUSIONS: Vertebral augmentation procedures provide pain relief for a majority of patients regardless of underlying fracture etiology. There was no difference in pain outcomes among procedure types. Age and sex may be predictive of pain outcomes.

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Year:  2009        PMID: 19465306     DOI: 10.1016/j.jvir.2009.01.037

Source DB:  PubMed          Journal:  J Vasc Interv Radiol        ISSN: 1051-0443            Impact factor:   3.464


  8 in total

1.  Percutaneous vertebroplasty in vertebral compression fractures of benign or malignant origin: a prospective study of 1188 patients with follow-up of 12 months.

Authors:  Anastasios Mpotsaris; Razmin Abdolvahabi; Bastian Hoffleith; Janpeter Nickel; Ali Harati; Christian Loehr; Chun Hee Gerdes; Svenja Hennigs; Werner Weber
Journal:  Dtsch Arztebl Int       Date:  2011-05-13       Impact factor: 5.594

2.  The association between the duration of preoperative pain and pain improvement in vertebral augmentation: a meta-analysis.

Authors:  A Ehteshami Rad; M T Luetmer; M H Murad; D F Kallmes
Journal:  AJNR Am J Neuroradiol       Date:  2011-09-01       Impact factor: 3.825

3.  Osteoplasty: Percutaneous Bone Cement Injection beyond the Spine.

Authors:  Giovanni Carlo Anselmetti
Journal:  Semin Intervent Radiol       Date:  2010-06       Impact factor: 1.513

4.  Safety and effectiveness of sacroplasty: a large single-center experience.

Authors:  A C Gupta; R V Chandra; A J Yoo; T M Leslie-Mazwi; D L Bell; B P Mehta; T L Vanderboom; J D Rabinov; M Larvie; J A Hirsch
Journal:  AJNR Am J Neuroradiol       Date:  2014-07-10       Impact factor: 3.825

5.  Number Needed to Treat with Vertebral Augmentation to Save a Life.

Authors:  J A Hirsch; R V Chandra; N S Carter; D Beall; M Frohbergh; K Ong
Journal:  AJNR Am J Neuroradiol       Date:  2019-12-19       Impact factor: 3.825

6.  Insufficiency fractures of the sacrum following stereotactic body radiotherapy for sacral tumors.

Authors:  Anuradha Thiagarajan; Larry Pan; Joan Zatcky; George Krol; Patrick J Boland; Yoshiya Yamada
Journal:  J Radiosurg SBRT       Date:  2014

7.  Predictive Factors for Sustained Pain after (sub)acute Osteoporotic Vertebral Fractures. Combined Results from the VERTOS II and VERTOS IV Trial.

Authors:  Cristina E Firanescu; Alexander Venmans; Jolanda de Vries; Paul Lodder; Marinus C Schoemaker; Albert J Smeets; Esther Donga; Job R Juttmann; Karen Schonenberg; Caroline A H Klazen; Otto E H Elgersma; Frits H Jansen; Hendrik Fransen; Joshua A Hirsch; Paul N M Lohle
Journal:  Cardiovasc Intervent Radiol       Date:  2022-06-09       Impact factor: 2.797

8.  Vertebroplasty versus sham procedure for painful acute osteoporotic vertebral compression fractures (VERTOS IV): randomised sham controlled clinical trial.

Authors:  Cristina E Firanescu; Jolanda de Vries; Paul Lodder; Alexander Venmans; Marinus C Schoemaker; Albert J Smeets; Esther Donga; Job R Juttmann; Caroline A H Klazen; Otto E H Elgersma; Frits H Jansen; Alexander V Tielbeek; Issam Boukrab; Karen Schonenberg; Willem Jan J van Rooij; Joshua A Hirsch; Paul N M Lohle
Journal:  BMJ       Date:  2018-05-09
  8 in total

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