Arun-Kumar Kaliya-Perumal1,2, Tung-Yi Lin2. 1. Department of Orthopaedic Surgery, Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Melmaruvathur, Tamil Nadu, India. 2. Department of Orthopaedic Surgery, Spine Division, Bone and Joint Research Center, Chang Gung Memorial Hospital (Keelung Branch) and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Abstract
OVERVIEW OF LITERATURE: Elderly patients sustaining a trivial fall may develop vertebral compression fractures if they are predisposed to any factor that leads to decreased bone mineral density. Such patients suffer with severe pain and disability during the early healing stages. Percutaneous Vertebroplasty is mainly done to provide immediate pain relief and also believed to offer stability to the compressed vertebra by preventing further collapse. METHODS: Selected patients [n = 20; Age = 57.9 ± 7.9 years] with osteoporotic vertebral compression fracture of a single dorsolumbar vertebra were treated with percutaneous vertebroplasty after 2-3 weeks of conservative trail. Their Pain score was noted using numeric rating scale (NRS) before and after the procedure. Functional outcomes were analysed using Roland Morris Disability Questionnaire (RMDQ) score. RESULTS: NRS pain score before procedure was 8.3 ± 0.6. RMDQ score before procedure was 21.6 ± 0.5. Third post procedural day NRS pain score was 4.7 ± 1.2 (p < 0.0001), denoting significant decrease in pain. Functional outcome analysis using RMDQ score showed an average of 87 ± 6.1 percent improvement (p < 0.0001), by 6 weeks following procedure. Considering pre-injury status all patients were in their best possible functional state by 6 weeks. CONCLUSIONS: Percutaneous Vertebroplasty serves its purpose adequately and economically. Under controlled circumstances, it offers immediate pain relief and stability, leading to early recovery in selective patients. Yet, underlying poor bone mineral density status needs to be treated. STUDY DESIGN: Observational Case Series (Level 4).
OVERVIEW OF LITERATURE: Elderly patients sustaining a trivial fall may develop vertebral compression fractures if they are predisposed to any factor that leads to decreased bone mineral density. Such patients suffer with severe pain and disability during the early healing stages. Percutaneous Vertebroplasty is mainly done to provide immediate pain relief and also believed to offer stability to the compressed vertebra by preventing further collapse. METHODS: Selected patients [n = 20; Age = 57.9 ± 7.9 years] with osteoporotic vertebral compression fracture of a single dorsolumbar vertebra were treated with percutaneous vertebroplasty after 2-3 weeks of conservative trail. Their Pain score was noted using numeric rating scale (NRS) before and after the procedure. Functional outcomes were analysed using Roland Morris Disability Questionnaire (RMDQ) score. RESULTS: NRS pain score before procedure was 8.3 ± 0.6. RMDQ score before procedure was 21.6 ± 0.5. Third post procedural day NRS pain score was 4.7 ± 1.2 (p < 0.0001), denoting significant decrease in pain. Functional outcome analysis using RMDQ score showed an average of 87 ± 6.1 percent improvement (p < 0.0001), by 6 weeks following procedure. Considering pre-injury status all patients were in their best possible functional state by 6 weeks. CONCLUSIONS: Percutaneous Vertebroplasty serves its purpose adequately and economically. Under controlled circumstances, it offers immediate pain relief and stability, leading to early recovery in selective patients. Yet, underlying poor bone mineral density status needs to be treated. STUDY DESIGN: Observational Case Series (Level 4).
Authors: En Loong Soon; Adriel Zhijie Leong; Jean Chiew; Arun-Kumar Kaliya-Perumal; Chun Sing Yu; Jacob Yoong-Leong Oh Journal: Asian Spine J Date: 2019-03-15