Abstract

BACKGROUND :The vertebral compression fractures are diagnosed in large numbers because of increasing incidence of osteoporosis. They are treated conservatively with variable outcomes causing high morbidity due to deformities and pain. Minimally invasive spine surgery, by the way of vertebroplasty is good modality to stabilize the vertebral body to reduce pain and prevent long term deformity is getting acceptable, particularly in geriatric age group where major open surgeries are high risk.PURPOSE: To study long term effectiveness of the 'Vertebroplasty' for osteoporotic vertebral fractures.To study usefulness of the indigenous instrumentation [AB NEEDLE] for vertebroplasty.STUDY DESIGN: Retrospective study done over 4 years or more to study usefulness of the 'Vertebroplasty' particularly of geriatric age group patients. The geriatric patients are high risk for the extensive spine surgery, hence there is need for having Minimally Invasive methods to treat this osteoporotic population. PATIENT SAMPLE: 40 patients [27females and 13 males] in the age group of 60 to 90 years of age who had osteoporotic compression fractures were treated by 'PERCUTANEOUS VERTEBROPLASTY' studied for 6 years postoperatively. Study group patients were operated from the period of January2003 to December 2003 were analyzed. Locally made vertebroplasty needle device was used for all these cases. This device has been patented recently. OUTCOME MEASURES: The assessment was done as follows:1] Subjective: pain relief and ability to do Activities of daily living [ADL].2] Objective: VAS score [Visual Analogue score for pain], healing of the fractures on x-rays. Patients were followed up 24 hours, 4 weeks, 12 weeks, 6 and 12 months and 48 months postoperatively. METHODS: These 40 patients who had painful osteoporotic fractures ,who did not do well with conservative treatment, were high risk due to medical illnesses underwent percutaneous vertebroplasty using indigenously developed instruments. The history of the fractures was from 3weeks to 2 years and had progressive pain and deformity affecting ADL.RESULTS: All patients had significant improvement of VAS by 50% or more within 24 hours and activities of daily living started by next day. Good results were maintained even after 48 moths of the index surgery.There was no fresh adjacent level fractures.CONCLUSIONS: The results of this series are comparable to the one-presented by2MAC, kwok & Wong [2002]. Distinct advantages being:1]All patients had excellent pain relief and all the fractures united.2] Single day hospitalization or as a day care, local anaesthesia, less morbidity.3] Reduction of cost by indigenous instrumentation.Vertebroplasty is an excellent Minimally Invasive procedure for osteoporotic fractures of the geriatric patients.