Abstract

Long term results of vertebral augmentation in 260 consecutive pathological vertebral fractures H. El-Maghraby, S Joshi, A. Shad, M. Khan, C. Thakker, and J. Yeh Department of Neurosurgery, Department of Interventional Neuro-Radiology, University Hospital Coventry & Warwick and the Royal London Hospital, United Kingdom Background: Pathological vertebral fractures are associated with significant pain and disability. Vertebral augmentation has been gaining popularity in treating such conditions. Aim of the study: To evaluate the long term results of Precutanous vertebral augmentation Design of study: Prospective interventional cohort study Outcome measures: Visual Analogue Scale (VAS) for pain, Oswestry Disability Index (ODI) for daily activities, reduction of pain prescription medications and radiological effects as Vertebral Body Height Restoration, Kyphotic and Wedge angle corrections. Methods: From August 2003 to August 2009, 197 patients with 260 consecutive pathological vertebral fractures were enrolled. Results: 198 patients with 260 pathological fractures were due to 55% tumours, 21 % osteoporosis and 24 % traumatic. Age ranged from 19-90 years with mean of 68 years. Follow up ranged from 6 months to 4.4 years with mean of 25 months. All patients sustained improvement of pain and reduction of disability with mean reduction of Visual Analogue Scale (VAS) of 5.7 (1.2) and mean reduction of Oswestry Disability Index (ODI) of 45 (5.5) (p<.001). Pain prescription medications were stopped in 50%, reduced in 30%, unchanged in 16% and increased in 4% due to disease progression. The mean Anterior Vertebral Body Height Restoration, Kyphotic angle correction and Wedge angle correction were 6.6 %, 4.2 and 3.65 respectively. The main procedure related complications consisted of one symptomatic extra-vertebral cement leakage resulted in foot drop and required open decompression, one nerve root contusion with transient radiculopathy, one further collapse and one wound infection. Conclusion: Precutanous vertebral augmentation significantly improves pain and disability with maintained long term results.