scholarly journals Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial

The Lancet ◽  
2010 ◽  
Vol 376 (9746) ◽  
pp. 1085-1092 ◽  
Author(s):  
Caroline AH Klazen ◽  
Paul NM Lohle ◽  
Jolanda de Vries ◽  
Frits H Jansen ◽  
Alexander V Tielbeek ◽  
...  
2019 ◽  
Vol 27 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Lin Zhang ◽  
Pei Zhai

Background. Osteoporotic vertebral compression fractures (OVCFs) are common in older patients, which can cause back pain and even increase morbidity. However, the optimal therapy for patients with OVCFs remains unknown. Percutaneous vertebroplasty (PVP), a minimally invasive procedure, has been a therapy option that is known to be effective in the pain management. Aim. The meta-analysis aims to summarize current best evidence on the efficacy of PVP and conservative treatment (CT) for pain management and functional results among OVCFs patients. Methods. We searched the publications on comparison of the efficacy of PVP versus CT for OVCFs patients up to November 2018. After rigorous reviewing on the quality, the data were extracted from eligible trials. All trials analyzed the summary hazard ratios of the endpoints of interest. Results. Moderate-strong evidence indicated that PVP had benefits on pain relief at 1 week and 1 month, but not at 3 months. With regard to the quality of life, no significant differences were found in the Roland-Morris Disability Questionnaire (RMDQ). However, there is significant difference in terms of EuroQol and Quality of Life Questionnaire of the European Foundation for Osteoporosis but not the RMDQ. Moreover, there were no any benefit in terms of vertebral fracture between groups. Conclusions. The meta-analysis showed that patients treated with vertebroplasty were associated with better pain relief and improved quality of life, without increasing the incidence of vertebral fracture compared with the CT group.


2019 ◽  
Vol 8 (4) ◽  
pp. 501
Author(s):  
Fu-Cheng Kao ◽  
Yu-Jui Huang ◽  
Ping-Yeh Chiu ◽  
Ming-Kai Hsieh ◽  
Tsung-Ting Tsai

The aim of our study was to investigate the association between global spinal alignment, spinopelvic parameters, and outcomes of osteoporotic vertebral compression fractures (OVCF). Patients with vertebral compression fractures seen at our hospital between October 2017 and November of 2018 with a bone mineral density (BMD) T-score < −2.5 were recruited for the study. Surgical intervention was performed after eight weeks of conservative treatment depending on clinical symptoms and the willingness of patients. Spinopelvic and sagittal alignment parameters were compared between patients who had surgery and those that did not. Seventy-nine patients were included in the study. Twenty-five patients (31.6%, mean age: 73.28 ± 9.78 years) received surgery, and 54 (68.3%, mean age: 73 ± 8.58 years) conservative treatment only. Pelvic tilt, pelvic incidence, and local kyphotic angle were statistically different between the groups (all p < 0.05). A sagittal vertical axis ≥ 50 mm, distance between the C7 plumb line and the center of the fractured vertebra (DSVA) ≥ 60 mm, pelvic incidence outside of the range of 44 to 62°), and pelvic tilt ≥ 27° were associted with the need for surgical intervention. Measurement of spinopelvic parameters can predict the need for surgery in patients with OVCF.


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