Efficacy and safety of vertebral augmentation techniques in patients with osteoporotic vertebral compression fractures: A single center, retrospective, observational study

Abstract

Background

Back pain secondary to osteoporotic vertebral compression fractures (OVCF) is a common global health problem that is frequently overlooked. For some patients, conservative management (CM) is inadequate to treat the pain associated with OVCF. This subset of patients are often candidates for interventional vertebral augmentation techniques (VAT). Multiple studies have shown significant pain reduction, height restoration, reduction in hospitalization time, morbidity and mortality in patients treated with VAT as compared with those patients treated with CM. This study examines if the previously published trials are consistent with outcomes in a real-world cohort of patients in interventional pain practices following VAT.

Objectives

The purpose of this retrospective databased analysis was to further investigate the efficacy and safety of percutaneous vertebral augmentation techniques in patients suffering from osteoporotic vertebral compression fractures in our center.

Study design

Retrospective study.

Setting

A single-center study.

Patients and methods

We have included data from a total of 42 patients (26 females, 16 males) with diagnosis of OVCF that received VAT at our center between January 2023 and June 2024. Efficacy data included pre-procedure, 2-week, 1-month and 3-month follow-up numerical rating scale (NRS) pain scores when available.

Results

The mean pain score using NRS was 7.5 (n = 45), 3.24 (n = 44), 3.65 (n = 21) and 2.7 (n = 15) at pre-procedure, 2-week, 1-month and 3-month follow-up (P < 0.001), respectively. At the 2-week follow up, 44 %, 16 %, 20 % and 13 % of patients (n = 45) had NRS pain score reduction between 76 and 100 %, 51–75 %, 26–50 % and 0–25 % (P ≤ 0.05), respectively. At the 1-month follow-up visit, 24 %, 33 %, 14.3 % and 24 % of patients (n = 21) had NRS pain score reduction between 76 and 100 %, 51–75 %, 26–50 % and 0–25 % (P ≤ 0.05), respectively. At the 3-month follow-up visit, 60 %, 6.7 %, 6.7 % and 20 % of patients (n = 15) had NRS pain score reduction between 76 and 100 %, 51–75 %, 26–50 % and 0–25 % (P ≤ 0.05), respectively. This indicates significant differences in NRS pain scores across the different time points. There was a high dropout rate at the 3-month follow up visit most likely due to patient's pain improving post procedure.

Limitations

This was a single-center retrospective study with a small sample size and relatively short follow-up time.

Conclusion

VAT are effective and safe procedures for patients suffering from OCVF. However, proceduralists must be aware of patient-specific risk factors to prevent possible complications.