VERTEBROPLASTY IN BONE FRAGILITY FRACTURES AND TUMOR FRACTURES: RISKS AND BENEFITS

VERTEBROPLASTIA EM FRATURAS POR FRAGILIDADE ÓSSEA E TUMORAIS: RISCOS E BENEFÍCIOS

VERTEBROPLASTIA EN FRACTURAS POR FRAGILIDAD ÓSEA Y TUMORALES: RIESGOS Y BENEFICIOS

ABSTRACT

Objective:

To evaluate the results of percutaneous vertebroplasty (PV) in spinal fragility fractures (osteoporosis/tumor), analyzing possible complications.

Method:

We evaluated 33 patients with spinal fractures (FXV) due to osteoporosis or tumor who underwent PV between January and November 2021. A physical examination was performed, obtaining the history and risk factors for bone fragility/tumor and a radiological evaluation of the spine to verify FXV. Genant’s semiquantitative method was used for postoperative classification, the VAS score, and a disability questionnaire (ODI). A radiologist evaluated tomographic control to quantify vertebral filling and extravasation, determining where they occurred.

Results:

46 vertebrae of 33 patients were operated on, with a mean age of 71 years, and 11 patients with more than one level of surgery. Of the total, 13 patients had tumor fractures, and 20 had fractures due to insufficiency. PMMA extravasation was observed in 31 vertebrae, most frequently in the External Vertebral Venous Plexus (23), Discal Body (9), Anterior Epidural Recess (4), Pulmonary Vessels (4), Internal Vertebral Venous Plexus (3), Inferior Cava (2), Adipose Plane (2) and Azygos Vein (1). No patient had clinical complications. Furthermore, the mean preoperative VAS was eight, the postoperative one was 3, the mean preoperative ODI was 56, and the postoperative one was 30.

Conclusion:

PMMA extravasation was frequent in several locations and levels without any clinical complications. VP proved to be effective in improving pain and function. Level III; Longitudinal Retrospective Cohort Study.

Keywords:
Spine; Osteoporosis; Tumor; Vertebroplasty; Pathological Fracture