When to perform vertebroplasty? A retrospective analysis from a single center and a review of the literature

When to perform vertebroplasty? A retrospective analysis from a single center and a review of the literature

Authors

  • Laura Evangelista Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
  • Luca Giuliani Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
  • Valeria Pagliei Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
  • Marco Varrassi Neuroradiology and Interventional Radiology, San Salvatore Hospital, L’Aquila, Italy
  • Federico Bruno Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM) – SIRM Foundation, via della Signora 2, Milan, Italy
  • Pierpaolo Palumbo Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM) – SIRM Foundation, via della Signora 2, Milan, Italy
  • Francesco Arrigoni Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
  • Alessandra Splendiani Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
  • Ernesto Di Cesare Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
  • Carlo Masciocchi Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
  • Antonio Barile Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy https://orcid.org/0000-0003-0253-3583

Keywords:

vertebroplasty, vertebral fractures, interventional radiology

Abstract

Background and aim: To establish an optimal timing for vertebroplasty in order to obtain a clinically important pain reduction and improving quality of live in patients with osteoporotic or traumatic vertebral fractures. Methods: This study includes 22 vertebroplasty procedures performed from October 2018 to July 2020 in 21 patients with traumatic or osteoporotic vertebral fractures (19 female, two men; age between 53 and 89 years). All treatments were executed under fluoroscopic guidance using 11 or 13 G needle through transpedicular or costovertebral unilateral approach. Each patient underwent conscious sedation, continuously monitored by an anesthesiologist. Preoperative MRI images, obtained by 3T or 1.5T MRI scanner, always showed bone marrow edema. The VAS scale and Roland Morris disability questionnaire (RMdq) were administered to patients before and after the treatment to evaluate pain and life quality. Results: 7 patients were treated in the first month after the injury, one was treated twice; 8 patients in the second month, 6 in the third. We observed a reduction of: 5.5 points in the vas scale, 10.3 in the RMdq in the first month; 5.6 points vas, 11.6 points RMdq in the second month; 4 points vas and 9.75 points RMdq in the third month.
Conclusions: This study demostrated that, in our preliminary experience, vertebroplasty has the best outcome if performed at 2 months from injury.

References

Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with oste-oporotic fractures. Osteoporos Int 2006;17: 1726–33

Filippiadis DK, Marcia S, Masala S, et al. Percutaneous Vertebroplasty and Kyphoplasty: Cur-rent Status, New Developments and Old Controversies. Cardiovasc Intervent Radiol. 2017 Dec;40(12):1815-1823

Cazzato RL, Arrigoni F, Boatta E, et al. (2019) Percutaneous management of bone metastases: state of the art, interventional strategies and joint position statement of the Italian College of MSK Radiology (ICoMSKR) and the Italian College of Interventional Radiology (ICIR). Radiol Med 124 (1):34-49

Arrigoni F, Bruno F, Zugaro L, et al. (2018) Developments in the management of bone metastases with interventional radiology. Acta Biomed 89 (1-S):166-174

Giordano AV, Arrigoni F, Bruno F, et al. (2017) Interventional Radiology Management of a Rup-tured Lumbar Artery Pseudoaneurysm after Cryoablation and Vertebroplasty of a Lumbar Metas-tasis. Cardiovasc Intervent Radiol 40 (5):776-779

Reinhold M, Knop C, Beisse R, et al.: Operative treatment of traumatic fractures of the thoracic and lumbar spinal column. Part I: epidemiology. Unfallchirurg 2009; 112: 33–42

Muto M, Giurazza F, Guarnieri G, et al. (2017) Percutaneous Treatment of Vertebral Fractures. Semin Musculoskelet Radiol 21 (3):349-356

Hoyt D, Urits I, Orhurhu V, et al. Current Concepts in the Management of Vertebral Compression Fractures. Curr Pain Headache Rep. 2020 Mar 20;24(5):16

Lukert BP. Vertebral compression fractures: how to manage pain, avoid disability. Geriatrics 1994;49:22-6

Lyles KW. Management of patients with vertebral compression fractures. Pharmacotherapy 1999; 19 (1 pt 2): 21s-4s

Wu SS, Lachmann E, Nagler W. Current medical, rehabilitation, and surgical management of ver-tebral compression fractures. J Women Health (Larchmt) 2003;12(1):17-26

Tezer M, Erturer RE, Ozturk C et al. Conservative treatment of fractures of the thoracolumbar spine. Int Orthop 2005;29:78-82

Silverman SL. The clinical consequences of vertebral compression fracture. Bone 2009; 13(Suppl 2):27-31

Gold DT. The clinical impact of vertebral fractures: quality of life in women with osteoporosis. Bone 1996;18(Suppl 3):185-9

Convertino VA, Bloomfield SA, Greenleaf JF. An overview of the issues: physiological effects of bed rest and restricted physical activity. Med Sci Sports Exerc 1997;29:187-90

Galibert P, Deramond H, Rosat P, et al. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 1987; 33(2):166-8

Mathis JM, Cho C. Percutaneous vertebroplasty. In: Mathis JM, Golovac S, editors. Image-guided spine interventions. New York: Springer New York; 2010. P.249-278

Tsoumakidou, G., Too, C.W., Koch, G. et al. CIRSE Guidelines on Percutaneous Vertebral Augmentation. Cardiovasc Intervent Radiol 2017 Mar;40(3):331–342

Clark W, Bird P, Gonski P, et al. Safety and efficacy of vertebroplasty for acute painful osteopo-rotic fractures (VAPOUR): a multicentre, randomised, double-blind, placebo-controlled trial. Lan-cet. 2016 Oct 1;388(10052):1408-1416

Splendiani A, D'Orazio F, Patriarca L, et al. Imaging of post-operative spine in intervertebral disc pathology. Musculoskelet Surg 101 (Suppl 1):75-84

Bruno F, Smaldone F, Varrassi M, et al.MRI findings in lumbar spine following O2-O3 chemi-odiscolysis: A long-term follow-up. Interv Neuroradiol 23 (4):444-450. doi:10.1177/1591019917703784

Agostini A, Borgheresi A, Mari A, et al. Dual-energy CT: theoretical principles and clinical appli-cations. Radiol Med 124 (12):1281-1295

Buffa V, Solazzo A, D'Auria V, et al. Dual-source dual-energy CT: dose reduction after endovas-cular abdominal aortic aneurysm repair. Radiol Med 119 (12):934-941

Arrigoni F, Barile A, Zugaro L, et al. CT-guided radiofrequency ablation of spinal osteoblastoma: treatment and long-term follow-up. Int J Hyperthermia 34 (3):321-327

Arrigoni F, Gregori L, Zugaro L, et al. MRgFUS in the treatment of MSK lesions: A review based on the experience of the University of L'Aquila, Italy. Translational Cancer Research 3 (5):442-448

Arrigoni F, Napoli A, Bazzocchi A, et al. Magnetic-resonance-guided focused ultrasound treat-ment of non-spinal osteoid osteoma in children: multicentre experience. Pediatr Radiol 49 (9):1209-1216

Barile A, Quarchioni S, Bruno F, et al. Interventional radiology of the thyroid gland: critical re-view and state of the art. Gland Surg 7 (2):132-146

Bruno F, Arrigoni F, Palumbo P, et al. The Acutely Injured Wrist. Radiol Clin North Am 57 (5):943-955

Bruno F, Arrigoni F, Palumbo P, et al New advances in MRI diagnosis of degenerative osteoar-thropathy of the peripheral joints. Radiol Med 124 (11):1121-1127

Bruno F, Barile A, Arrigoni F, et al Weight-bearing MRI of the knee: a review of advantages and limits. Acta Biomed 89 (1-S):78-88

Chianca V, Albano D, Messina C, et al. Rotator cuff calcific tendinopathy: from diagnosis to treatment. Acta Biomed 89 (1-S):186-196

D'Orazio F, Splendiani A, Gallucci M 320-Row Detector Dynamic 4D-CTA for the Assessment of Brain and Spinal Cord Vascular Shunting Malformations. A Technical Note. Neuroradiol J 27 (6):710-717

De Cecco CN, Buffa V, Fedeli S, et al. Preliminary experience with abdominal dual-energy CT (DECT): true versus virtual nonenhanced images of the liver. Radiol Med 115 (8):1258-1266

Di Cesare E, Gennarelli A, Di Sibio A, et al. Image quality and radiation dose of single heartbeat 640-slice coronary CT angiography: a comparison between patients with chronic atrial fibrillation and subjects in normal sinus rhythm by propensity analysis. Eur J Radiol 84 (4):631-636

Di Pietto F, Chianca V, de Ritis R, et al. Postoperative imaging in arthroscopic hip surgery. Mus-culoskelet Surg 101 (Suppl 1):43-49

Gravina GL, Marampon F, Muzi P, et al PXD101 potentiates hormonal therapy and prevents the onset of castration-resistant phenotype modulating androgen receptor, HSP90, and CRM1 in pre-clinical models of prostate cancer. Endocr Relat Cancer 20 (3):321-337

Gravina GL, Marampon F, Sherris D, et al.Torc1/Torc2 inhibitor, Palomid 529, enhances radia-tion response modulating CRM1-mediated survivin function and delaying DNA repair in prostate cancer models. Prostate 74 (8):852-868

Liguori A, Galli F, Gurgitano M, et al. Clinical and instrumental assessment of herniated discs af-ter nucleoplasty: a preliminary study. Acta Biomed 89 (1-S):220-229

Manetta R, Palumbo P, Gianneramo C, et al. Correlation between ADC values and Gleason score in evaluation of prostate cancer: multicentre experience and review of the literature. Gland Surg 8 (Suppl 3):S216-S222

Marampon F, Gravina GL, Festuccia C, et al. Vitamin D protects endothelial cells from irradia-tion-induced senescence and apoptosis by modulating MAPK/SirT1 axis. J Endocrinol Invest 39 (4):411-422

Masciocchi C, Conchiglia A, Gregori LM, et al. Critical role of HIFU in musculoskeletal interven-tions. Radiol Med 119 (7):470-475

Masciocchi C, Conti L, D’Orazio F, et al. Errors in musculoskeletal MRI. In: Romano L, Pinto A (eds) Errors in Radiology. Springer Milano, pp 209-217

Rossi A, Bustini M, Prosperini P, et al. Neuromorphological abnormalities in schizophrenic pa-tients with good and poor outcome. Acta Psychiatr Scand 101 (2):161-166

Scarpino M, Lolli F, Lanzo G, et al. Neurophysiology and neuroimaging accurately predict poor neurological outcome within 24 hours after cardiac arrest: The ProNeCA prospective multicentre prognostication study. Resuscitation 143:115-123

Silvestri E, Barile A, Albano D, et al. Interventional therapeutic procedures in the musculoskeletal system: an Italian Survey by the Italian College of Musculoskeletal Radiology. Radiol Med 123 (4):314-321

Varrassi M, Cobianchi Bellisari F, Bruno F, et al. High-resolution magnetic resonance imaging at 3T of pituitary gland: advantages and pitfalls. Gland Surg 8 (Suppl 3):S208-S215

Zoccali C, Arrigoni F, Mariani S, et al. An unusual localization of chondroblastoma: The triradiate cartilage; from a case report a reconstructive technique proposal with imaging evolution. J Clin Or-thop Trauma 8 (Suppl 1):S48-S52

Zoccali C, Rossi B, Zoccali G, et al. A new technique for biopsy of soft tissue neoplasms: a pre-liminary experience using MRI to evaluate bleeding. Minerva Med 106 (2):117-120

Chandra, R. V., Maingard, J., Asadi, H., et al. Vertebroplasty and Kyphoplasty for Osteoporotic Vertebral Fractures: What Are the Latest Data? American Journal of Neuroradiology, 39(5), 798–806.

Voormolen MH, Mali WP, Lohle PN, et al. Percutaneous vertebroplasty compared with optimal pain medication treatment: short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures. The VERTOS study. AJNR Am J Neuroradiol 2007; 28: 555–60.

Yamato TP, Maher CG, Saragiotto BT, et al. The Roland-Morris Disability Questionnaire: one or more dimensions? Eur Spine J. 2017 Feb;26(2):301-308

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Published

10-09-2021

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1.
When to perform vertebroplasty? A retrospective analysis from a single center and a review of the literature. Acta Biomed [Internet]. 2021 Sep. 10 [cited 2024 Jun. 23];92(S5):e2021402. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/11955