Chronic Painful Osteoporotic Vertebral Compression Fractures of Thoracolumbar Spine: Percutaneous Vertebroplasty versus Conservative Management among Egyptian Patients

Background Data: Vertebral augmentation procedures are widely used today in treating acute and subacute osteoporotic vertebral compression fractures (OVCFs). However, percutaneous vertebroplasty for patients with chronic painful OVCFs has been less well studied. Study Design: A prospective cohort st...

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Autores principales: Khaled Hassan, Mohammad El-Sharkawi
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Lenguaje:EN
Publicado: Egyptian Spine Association 2015
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Acceso en línea:https://doaj.org/article/c135baf7b2f4440bb1b3ec7903324c68
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spelling oai:doaj.org-article:c135baf7b2f4440bb1b3ec7903324c682021-12-02T03:27:18ZChronic Painful Osteoporotic Vertebral Compression Fractures of Thoracolumbar Spine: Percutaneous Vertebroplasty versus Conservative Management among Egyptian PatientsDOI:10.21608/ESJ.2015.39512314-89502314-8969https://doaj.org/article/c135baf7b2f4440bb1b3ec7903324c682015-04-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_3951.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Vertebral augmentation procedures are widely used today in treating acute and subacute osteoporotic vertebral compression fractures (OVCFs). However, percutaneous vertebroplasty for patients with chronic painful OVCFs has been less well studied. Study Design: A prospective cohort study. Purpose: to compare the efficacy and safety of percutaneous vertebroplasty with conservative treatment for management of chronic painful OVCFs in the thoracolumbar spine among Egyptian patients. Patients and Methods: Ninety-eight patients presented with acute OVCFs during the period from October 2009 to December 2013. They were treated conservatively and followed for at least 3 months. Thereafter, 38 patients were excluded from this study as significant pain improvement was noticed in 32 patients and 6 didn't fulfill the inclusion criteria of this study. The remaining 60 patients (38 females and 22 males, mean age: 65.42±8.63) with chronic painful OVCFs were included in this prospective cohort study. Twenty-eight patients were treated with percutaneous vertebroplasty (Vertebroplasty group). Thirty two patients refused surgical treatment and constituted the control group (Conservative group). All patients were evaluated with X-rays and CT scan, where Cobb angle and the anteroposterior height comparison (APHC) were measured. Overall pain and quality of life were assessed with the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) respectively. Results: All patients were followed for at least 12 months. Statistical analysis of the demographic data of the two groups could not reveal any significant differences. At latest follow up, there was significant improvement in Cobb angle and APHC in Vertebroplasty group when compared with Conservative group (P=0.001). Three patients in the Conservative group (9.37%) went into nonunion, while all patients in the Vertebroplasty group showed radiological evidence of good stability at latest follow up. A significant improvement of VAS Scores (P=0.001) and ODI (P=0.001) was observed in theVertebroplasty group when compared to the Conservative group at the latest follow up. Conclusion: Percutaneous vertebroplasty is safe and effective in treatment of chronic painful osteoporotic vertebral compression fractures with significantly better radiological and clinical outcomes when compared with conservative management. (2015ESJ086)Khaled Hassan Mohammad El-SharkawiEgyptian Spine AssociationarticleChronic painful osteoporotic vertebral compression fracturevertebroplastyconservative treatmentnonunionNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 14, Iss 1, Pp 4-14 (2015)
institution DOAJ
collection DOAJ
language EN
topic Chronic painful osteoporotic vertebral compression fracture
vertebroplasty
conservative treatment
nonunion
Neurology. Diseases of the nervous system
RC346-429
spellingShingle Chronic painful osteoporotic vertebral compression fracture
vertebroplasty
conservative treatment
nonunion
Neurology. Diseases of the nervous system
RC346-429
Khaled Hassan
Mohammad El-Sharkawi
Chronic Painful Osteoporotic Vertebral Compression Fractures of Thoracolumbar Spine: Percutaneous Vertebroplasty versus Conservative Management among Egyptian Patients
description Background Data: Vertebral augmentation procedures are widely used today in treating acute and subacute osteoporotic vertebral compression fractures (OVCFs). However, percutaneous vertebroplasty for patients with chronic painful OVCFs has been less well studied. Study Design: A prospective cohort study. Purpose: to compare the efficacy and safety of percutaneous vertebroplasty with conservative treatment for management of chronic painful OVCFs in the thoracolumbar spine among Egyptian patients. Patients and Methods: Ninety-eight patients presented with acute OVCFs during the period from October 2009 to December 2013. They were treated conservatively and followed for at least 3 months. Thereafter, 38 patients were excluded from this study as significant pain improvement was noticed in 32 patients and 6 didn't fulfill the inclusion criteria of this study. The remaining 60 patients (38 females and 22 males, mean age: 65.42±8.63) with chronic painful OVCFs were included in this prospective cohort study. Twenty-eight patients were treated with percutaneous vertebroplasty (Vertebroplasty group). Thirty two patients refused surgical treatment and constituted the control group (Conservative group). All patients were evaluated with X-rays and CT scan, where Cobb angle and the anteroposterior height comparison (APHC) were measured. Overall pain and quality of life were assessed with the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) respectively. Results: All patients were followed for at least 12 months. Statistical analysis of the demographic data of the two groups could not reveal any significant differences. At latest follow up, there was significant improvement in Cobb angle and APHC in Vertebroplasty group when compared with Conservative group (P=0.001). Three patients in the Conservative group (9.37%) went into nonunion, while all patients in the Vertebroplasty group showed radiological evidence of good stability at latest follow up. A significant improvement of VAS Scores (P=0.001) and ODI (P=0.001) was observed in theVertebroplasty group when compared to the Conservative group at the latest follow up. Conclusion: Percutaneous vertebroplasty is safe and effective in treatment of chronic painful osteoporotic vertebral compression fractures with significantly better radiological and clinical outcomes when compared with conservative management. (2015ESJ086)
format article
author Khaled Hassan
Mohammad El-Sharkawi
author_facet Khaled Hassan
Mohammad El-Sharkawi
author_sort Khaled Hassan
title Chronic Painful Osteoporotic Vertebral Compression Fractures of Thoracolumbar Spine: Percutaneous Vertebroplasty versus Conservative Management among Egyptian Patients
title_short Chronic Painful Osteoporotic Vertebral Compression Fractures of Thoracolumbar Spine: Percutaneous Vertebroplasty versus Conservative Management among Egyptian Patients
title_full Chronic Painful Osteoporotic Vertebral Compression Fractures of Thoracolumbar Spine: Percutaneous Vertebroplasty versus Conservative Management among Egyptian Patients
title_fullStr Chronic Painful Osteoporotic Vertebral Compression Fractures of Thoracolumbar Spine: Percutaneous Vertebroplasty versus Conservative Management among Egyptian Patients
title_full_unstemmed Chronic Painful Osteoporotic Vertebral Compression Fractures of Thoracolumbar Spine: Percutaneous Vertebroplasty versus Conservative Management among Egyptian Patients
title_sort chronic painful osteoporotic vertebral compression fractures of thoracolumbar spine: percutaneous vertebroplasty versus conservative management among egyptian patients
publisher Egyptian Spine Association
publishDate 2015
url https://doaj.org/article/c135baf7b2f4440bb1b3ec7903324c68
work_keys_str_mv AT khaledhassan chronicpainfulosteoporoticvertebralcompressionfracturesofthoracolumbarspinepercutaneousvertebroplastyversusconservativemanagementamongegyptianpatients
AT mohammadelsharkawi chronicpainfulosteoporoticvertebralcompressionfracturesofthoracolumbarspinepercutaneousvertebroplastyversusconservativemanagementamongegyptianpatients
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