Abstract
We have reviewed the case records of 92 patients with avascular osteonecrosis following osteoporotic vertebral fracture treated by percutaneous vetebroplasty (PVP) with PMMA (polymethylmethacrylate). The mean age at the time of operation was 76 years (range 63-91 years). The mean follow-up period was 13 months (range 2-25 months).
Pain indicated on a visual analog scale was significantly decreased from a mean of 9.1 before PVP, to 1.9 immediately after operation, and to 3.0 after 12 months or more. Extravasation of a small amount of cement into the disc space and perispinus region was seen in 19.5% of the 123 procedures. These leaks were asymptomatic in all patients. Vertebral fracture in the vicinity of a cemented vertebra occurred in 21.7% of the 92 cases. They were treated with repeat PVP or the use of a spinal orthotic braces and had pain relief at the time of maximal follow-up. No severe complication occurred after PVP.
We conclude that PVP with PMMA is an effective and relatively safe procedure in the treatment of avascular osteonecrosis following osteoporotic vertebral fracture.
