| Comparative Study Between Vertebral Aumentative Treatment Versus
Conservative Treatment on Osteoporotic Vertebral Compression Fractures in
Elderly Patients Aged Over 65 Years |
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Sung Chan Shin , Jung Yul Park , Dong Jun Lim, Tae Hyung Cho , Sang Dae Kim |
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Department of neurosurgery, Korea University Ansan Hospital, Korea University School of Medicine, Ansan, Korea |
| 65세 이상의 골다공증성 압박골절 환자에 대한
척추성형술과 보전적 치료 결과의 비교 |
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신성찬ㆍ박정율ㆍ임동준ㆍ조태형ㆍ김상대 |
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고려대학교의료원 안산병원 신경외과 |
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| Abstract |
Objective
With today's rapid increase in elderly population, osteoporosis related vertebral fractures have become a
major concern. Vertebroplasty and kyphoplasty are vertebral augmentative procedures that usually provide immediate
pain relief and early ambulation for vertebral compression fractures. However, complications are not uncommon, although
mostly not serious, and may pose against the physiological state of aged spine, namely an increase in incidence of
additional fractures. The objective of this retrospective study is to compare whether vertebroplasty and kyphoplasty predispose
patients to the development of additional vertebral fractures, compared to natural course, with a specific focus
on adjacent vertebral fractures as well as long term evolution of low back pain.
Methods
We analyzed 96 patients with acute vertebral fractures admitted to our hospital between January 2000
and December 2006. Clinical characteristics and bone desitometry were assessed at baseline and Visual Analogue
Scale (VAS) score was measured at admission, 1 day and 12 weeks after treatment. We divided the patients into
two groups; (A) patients who underwent vertebroplasty or kyphoplasty, and (B) patients who were treated with conservative
methods
. The two groups were compared for age, gender, bone densitometry, VAS score at timed schedule
and incidence of additional vertebral fractures.
Results
Fifty-one patients were treated with either vertebroplasty or kyphoplasty and forty-five patients were
treated by conservative therapy alone. They were followed for a mean of 20 months and 29 months, respectively.
The baseline clinical characteristics, bone densitometry, and fracture data were similar in the two groups. Patients
in group A showed 18% incidence of subsequent fractures and second group showed 36%. Statistically, however,
there were no meaningful difference in two groups on new adjacent compression fracture and the rate of the new
fracture within 6 months. VAS scores between two groups also showed no statistical difference except the time
one day after procedure. Second group showed significant pain reduction at the time.
Conclusion
In this study, there were no differences in number of newly developed adjacent osteoporotic vertebral
compression fractures (OVCFs) in two groups and no differences in overall number of OVCFs that were developed
. However, a well designed, randomized controlled trial with larger population and longer follow up period will be
needed before making a justification on these issues. |
| Key Words:
Osteoporosis, Compression fracture, Kyphoplasty, Vertebroplasty, Conservative treatment |
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