Document Detail


Randomized controlled trial of percutaneous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures.
MedLine Citation:
PMID:  21375382     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Osteoporotic vertebral compression fractures (VCFs) are a major cause of increased morbidity in older patients. This randomized controlled trial compared the efficacy of percutaneous vertebroplasty (PV) versus optimal medical therapy (OMT) in controlling pain and improving the quality of life (QOL) in patients with VCFs. Efficacy was measured as the incidence of new vertebral fractures after PV, restoration of vertebral body height (VBH), and correction of deformity.
METHODS: Of 105 patients with acute osteoporotic VCFs, 82 were eligible for participation: 40 patients underwent PV and 42 received OMT. Primary outcomes were control of pain and improvement in QOL before treatment, and these were measured at 1 week and at 2, 6, 12, 24, and 36 months after the beginning of the treatment. Radiological evaluation to measure VBH and sagittal index was performed before and after treatment in both groups and after 36 months of follow-up.
RESULTS: The authors found a statistically significant improvement in pain in the PV group compared with the OMT group at 1 week (difference -3.1, 95% CI -3.72 to -2.28; p < 0.001). The QOL improved significantly in the PV group (difference -14, 95% CI -15 to -12.82; p < 0.028). One week after PV, the average VBH restoration was 8 mm and the correction of deformity was 8°. The incidence of new fractures in the OMT group (13.3%) was higher than in the PV group (2.2%; p < 0.01).
CONCLUSIONS: The PV group had statistically significant improvements in visual analog scale and QOL scores maintained over 24 months, improved VBH maintained over 36 months, and fewer adjacent-level fractures compared with the OMT group.
Authors:
Majid Reza Farrokhi; Ehsanali Alibai; Zohre Maghami
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2011-03-04
Journal Detail:
Title:  Journal of neurosurgery. Spine     Volume:  14     ISSN:  1547-5646     ISO Abbreviation:  J Neurosurg Spine     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-02     Completed Date:  2011-07-26     Revised Date:  2012-03-07    
Medline Journal Info:
Nlm Unique ID:  101223545     Medline TA:  J Neurosurg Spine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  561-9     Citation Subset:  IM    
Affiliation:
Neurosurgery Department, Shiraz University of Medical Sciences, Shiraz, Iran. farokhim@sums.ac.ir
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MeSH Terms
Descriptor/Qualifier:
Acetaminophen / therapeutic use
Aged
Aged, 80 and over
Analgesics, Non-Narcotic / therapeutic use
Analgesics, Opioid / therapeutic use
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Chi-Square Distribution
Codeine / therapeutic use
Disability Evaluation
Female
Fractures, Compression / drug therapy,  physiopathology,  surgery*
Humans
Ibuprofen / therapeutic use
Male
Middle Aged
Osteoporosis / drug therapy,  physiopathology,  surgery*
Pain / drug therapy*,  etiology,  physiopathology,  surgery*
Pain Measurement
Quality of Life
Questionnaires
Single-Blind Method
Spinal Fractures / drug therapy,  physiopathology,  surgery*
Treatment Outcome
Vertebroplasty / methods*
Chemical
Reg. No./Substance:
0/Analgesics, Non-Narcotic; 0/Analgesics, Opioid; 0/Anti-Inflammatory Agents, Non-Steroidal; 103-90-2/Acetaminophen; 15687-27-1/Ibuprofen; 76-57-3/Codeine
Comments/Corrections
Comment In:
J Neurosurg Spine. 2012 Feb;16(2):210; author reply 210-1   [PMID:  22077471 ]
J Neurosurg Spine. 2011 May;14(5):555-9; discussion 559-60   [PMID:  21375383 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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