HOME HELP CONTACT US FEEDBACK SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Résumé Full Text Full Text (PDF) Rapid Responses: Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Banerjee, S. Articles by Asch, M. R. Search for Related Content PubMed PubMed Citation Articles by Banerjee, S. Articles by Asch, M. R.

Back stab

Percutaneous vertebroplasty for severe back pain

Mark Otto Baerlocher, MD
Resident in the Radiology Program at the University of Toronto in Ontario

Murray R. Asch, MD FRCPC
Director of Interventional Radiology at the Lakeridge Health Corporation in Oshawa, Ont

Correspondence to: Susitna Banerjee, 47 Great Oak Private, Ottawa, ON K1G 6P7; telephone 613 733-4364; e-mailsbane059{at}uottawa.ca

OBJECTIVE To review the evidence supporting use of percutaneous vertebroplasty for relief of pain and mechanical stability in patients with vertebral compression fractures unrelieved by conventional measures.

QUALITY OF EVIDENCE Ovid MEDLINE was searched from January 1966 to December2006 for all English-language papers on vertebroplasty. The quality of evidence in these papers was graded according to the 4-point classification system of evidence-based medicine. Level II evidence currently supports use of vertebroplasty.

MAIN MESSAGE Vertebroplasty alleviates pain from vertebral compression fractures that result from osteoporosis, hemangiomas, malignancies, and vertebral osteonecrosis. Vertebroplasty has provided substantial pain relief in 60% to 100% of patients; has decreasedanalgesic use in 34% to 91% of patients; and has improved physical mobility in 29% to 100% of patients. Contraindications to vertebroplasty include asymptomatic compression fractures of the vertebral body, vertebra plana, retropulsed bone fragments or tumours, active infection, uncorrectable coagulopathy, allergy to the bone cement or opacification agent, severe cardiopulmonary disease, pregnancy, and pre-existing radiculopathy. The short-term complication rate was found to be 0.5% to 54%. Rare but serious complications include compression of the spinal cord or nerve root, infection, cement embolization causing pulmonary infarct and clinical symptoms, paradoxical embolization of the cerebral artery, and severe hematomas.

CONCLUSION Vertebroplasty is a safe and effective treatment for vertebral fractures that cannot be treated using conservative measures.

This article has been cited by other articles:

				J. O'Brien, M. O. Baerlocher, M. Asch, and A. Myers Role of radiology in geriatric care: A primer for family physicians Can Fam Physician, January 1, 2009; 55(1): 32 - 37. [Abstract] [Full Text] [PDF]