vertebroplasty
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Introduction
Also see kyphoplasty.
Indications
* of questionable value[8]
Procedure
- percutaneous procedure with analgesia
- performed by interventional radiologist
- a trocar is inserted through the vertebral pedicle & into the marrow of the vertebral body under fluoroscopic guidance
- polymethylmethacrylate cement is injected into the vertebral body where it hardens
Complications
- vertebroplasty associated with 25% increased likelihood of opioid therapy after 30 days (relative to sham)[5]
- not associated with increased risk of secondary fractures[8]
Notes
- utilization of vertebroplasty & kyphoplasty may be declining[6]
More general terms
Additional terms
References
- ↑ 1.0 1.1 1.2 Journal Watch 22(10):82, 2002 Peh WCG et al Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Radiology 223:121, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11930056
- ↑ 2.0 2.1 2.2 Journal Watch 23(6):49, 2003 Evans AJ et al Vertebral compression fractures: pain reduction and improvement in functional mobility after percutaneous polymethylmethacrylate vertebroplasty retrospective report of 245 cases. Radiology 226:366, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12563127
- ↑ 3.0 3.1 Buchbinder R et al, A Randomized Trial of Vertebroplasty for Painful Osteoporotic Vertebral Fractures N Eng J Med 361:557-568 August 6, 2009 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19657121 <Internet> http://content.nejm.org/cgi/content/short/361/6/557
Kallmes DF et al, A Randomized Trial of Vertebroplasty for Osteoporotic Spinal Fractures N Eng J Med 361:569-579 August 6, 2009 N Engl J Med. 2009 http://content.nejm.org/cgi/content/short/361/6/569
Weinstein JN Balancing Science and Informed Choice in Decisions about Vertebroplasty N Eng J Med 361:619-621 August 6, 2009 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19657127 <Internet> http://content.nejm.org/cgi/content/full/361/6/619 - ↑ Klazen CAH et al. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): An open-label randomised trial. Lancet 2010 Aug 10 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20701962
- ↑ 5.0 5.1 5.2 Staples MP et al Effectiveness of vertebroplasty using individual patient data from two randomised placebo controlled trials: Meta-analysis. BMJ 2011 Jul 12; 343:d395 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21750078
Wilson DJ. Vertebroplasty for vertebral fracture: On the basis of current evidence, cannot be recommended as the first line treatment. BMJ 2011 Jul 12; 343:d3470 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21750076 - ↑ 6.0 6.1 Long SS et al. Vertebroplasty and kyphoplasty in the United States: Provider distribution and guidance method, 2001-2010. AJR Am J Roentgenol 2012 Dec; 199:1358. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23169730
- ↑ 7.0 7.1 Clark W, Bird P, Gonski P, Diamond TH et al. Safety and efficacy of vertebroplasty for acute painful osteoporotic fractures (VAPOUR): A multicentre, randomised, double-blind, placebo-controlled trial. Lancet 2016 Aug 17; PMID: https://www.ncbi.nlm.nih.gov/pubmed/27544377
Hirsch JA, Chandra RV. Resurrection of evidence for vertebroplasty? Lancet 2016 Aug 17 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27544375 - ↑ 8.0 8.1 8.2 Mills ES et al. Secondary fracture rate after vertebral osteoporotic compression fracture is decreased by anti-osteoporotic medication but not increased by cement augmentation. J Bone Joint Surg Am 2022 Dec 21; 104:2178 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36223482 https://journals.lww.com/jbjsjournal/Abstract/2022/12210/Secondary_Fracture_Rate_After_Vertebral.6.aspx