Percutaneous transpedicular vertebroplasty using calcium phosphate cement for osteoporotic vertebral fractures: A prospective study of functional outcomes

Abstract

Context: Vertebral compression fractures are the most common osteoporotic fracture in old age group causing incapacitating pain and producing significant disability. Approximately one-third of these patients do not respond to traditional conservative treatments. Percutaneous vertebroplasty (PV) is a minimally invasive treatment option being increasingly used and traditionally being done using polymethyl methacrylate (PMMA), but it has some disadvantages. Calcium phosphate cement (CPC) is a new entity with many benefits over PMMA such as it being biodegradable, little or no heat generation during polymerization, and remodeling into healthy bone. Aims: The aim of this study was to analyze the functional outcome, restoration of wedge angle, and vertebral height after vertebroplasty in osteoporotic vertebral wedge compression fractures. Subjects and Methods: In our study, a total of 21 symptomatic patients (between 55 and 80 years of age), refractory to conservative treatment, having kyphosis and vertebral wedge collapse were included in the study. Pre- and postoperative comparisons were done clinically (Oswestry Disability Index and Visual Analog Scale [VAS] score) and radiologically. Statistical Analysis Used: SPSS software version 22.0 was used for statistical analysis. Results: Preoperatively in all patients, Oswestry disability score was >60% and VAS score >7 indicating severe disability. On subsequent follow-ups at 15 days, 1 month, 3 months, 6 months, and 9 months, we found a significantly reduced VAS score (<2) and Oswestry disability score (<20%) in 19/21 (90%) patients indicating very minimal residual disability in majority of the patients. Conclusions: Our study shows that PV using CPC is a promising new procedure with the benefits of quick improvement in mobility, decreased pain-related doctor visits, decreased nonsteroidal anti-inflammatory drugs usage postoperatively, and overall increased quality of life.

Keywords

• biodegradable bone cement substitutes
• calcium phosphate cement
• osteoporosis
• polymethyl methacrylate
• vertebral compression fractures
• vertebroplasty