Percutaneous vertebroplasty is no risk factor for new vertebral fractures and protects against further height loss (VERTOS IV)

Cristina E. Firanescu, Jolanda de Vries, Paul Lodder, Marinus C. Schoemaker, Albert J. Smeets, Esther Donga, Job R. Juttmann, Caroline A. H. Klazen, Otto E. H. Elgersma, Frits H. Jansen, Irene van der Horst, Marion Blonk, Alexander Venmans, Paul N. M. Lohle

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background:

Percutaneous vertebroplasty (PV) is an alternative option to treat pain after an osteoporotic vertebral compression fracture (OVCF). Controversy exists as to whether PV increases the risk of new OVCFs or prevents further vertebral height loss in treated levels. We assessed both during 1-year follow-up in patients with acute OVCF randomised to PV or a sham procedure.

Mehods:

VERTOS IV is a prospective, multicentre, randomised controlled trial comparing PV with sham therapy in 180 patients. NewOVCFs and further vertebral height loss were assessed at 3, 6, and 12 months.

Results:

After a median follow-up of 12 months (interquartile range (IQR) = 12-12) 31 new fractures were reported in 15 patients from the PV group and 28 new fractures in 19 patients from the sham group. The occurrence of new vertebral fractures did not significantly differ between the groups (χ2(1) = 0.83, p = 0.36, OR = .71, 95%CI = 0.33-1.50). There was no higher fracture risk of adjacent versus distant vertebrae. After sham procedure, further height loss of treated vertebrae occurred more frequently (7 patients (8%) in the PV group and 39 (45%) in the sham group (χ2(1) = 28.85, p < 0.001, OR = 9.84, 95%CI = 4.08-23.73)) and was more severe (p < .001) than after PV.

Conclusions:

The risk of further vertebral height loss is significantly lower after PV compared to a sham intervention, i.e. PV protectsagainst progressive vertebral height loss. In addition, PV does not increase the risk of new adjacent and distant OVCFs.

Original languageEnglish
Pages (from-to)991-1000
JournalCardiovascular and interventional radiology
Volume42
Issue number7
DOIs
Publication statusPublished - 2019

Keywords

  • Osteoporotic percutaneous vertebroplasty (PV)
  • Vertebral compression fracture (OVCF)
  • Visual analogue scale (VAS)
  • Polymethylmethacrylate (PMMA)
  • VERTOS IV
  • Randomised controlled trial (RCT)
  • COMPRESSION FRACTURES
  • RANDOMIZED-TRIAL
  • KYPHOPLASTY
  • MORTALITY
  • SECONDARY
  • MORBIDITY

Cite this

Firanescu, Cristina E. ; de Vries, Jolanda ; Lodder, Paul ; Schoemaker, Marinus C. ; Smeets, Albert J. ; Donga, Esther ; Juttmann, Job R. ; Klazen, Caroline A. H. ; Elgersma, Otto E. H. ; Jansen, Frits H. ; van der Horst, Irene ; Blonk, Marion ; Venmans, Alexander ; Lohle, Paul N. M. / Percutaneous vertebroplasty is no risk factor for new vertebral fractures and protects against further height loss (VERTOS IV). In: Cardiovascular and interventional radiology. 2019 ; Vol. 42, No. 7. pp. 991-1000.
@article{bd578364e25341cdbde41c4e0826699c,
title = "Percutaneous vertebroplasty is no risk factor for new vertebral fractures and protects against further height loss (VERTOS IV)",
abstract = "Background:Percutaneous vertebroplasty (PV) is an alternative option to treat pain after an osteoporotic vertebral compression fracture (OVCF). Controversy exists as to whether PV increases the risk of new OVCFs or prevents further vertebral height loss in treated levels. We assessed both during 1-year follow-up in patients with acute OVCF randomised to PV or a sham procedure.Mehods:VERTOS IV is a prospective, multicentre, randomised controlled trial comparing PV with sham therapy in 180 patients. NewOVCFs and further vertebral height loss were assessed at 3, 6, and 12 months.Results:After a median follow-up of 12 months (interquartile range (IQR) = 12-12) 31 new fractures were reported in 15 patients from the PV group and 28 new fractures in 19 patients from the sham group. The occurrence of new vertebral fractures did not significantly differ between the groups (χ2(1) = 0.83, p = 0.36, OR = .71, 95{\%}CI = 0.33-1.50). There was no higher fracture risk of adjacent versus distant vertebrae. After sham procedure, further height loss of treated vertebrae occurred more frequently (7 patients (8{\%}) in the PV group and 39 (45{\%}) in the sham group (χ2(1) = 28.85, p < 0.001, OR = 9.84, 95{\%}CI = 4.08-23.73)) and was more severe (p < .001) than after PV.Conclusions:The risk of further vertebral height loss is significantly lower after PV compared to a sham intervention, i.e. PV protectsagainst progressive vertebral height loss. In addition, PV does not increase the risk of new adjacent and distant OVCFs.",
keywords = "Osteoporotic percutaneous vertebroplasty (PV), Vertebral compression fracture (OVCF), Visual analogue scale (VAS), Polymethylmethacrylate (PMMA), VERTOS IV, Randomised controlled trial (RCT), COMPRESSION FRACTURES, RANDOMIZED-TRIAL, KYPHOPLASTY, MORTALITY, SECONDARY, MORBIDITY",
author = "Firanescu, {Cristina E.} and {de Vries}, Jolanda and Paul Lodder and Schoemaker, {Marinus C.} and Smeets, {Albert J.} and Esther Donga and Juttmann, {Job R.} and Klazen, {Caroline A. H.} and Elgersma, {Otto E. H.} and Jansen, {Frits H.} and {van der Horst}, Irene and Marion Blonk and Alexander Venmans and Lohle, {Paul N. M.}",
year = "2019",
doi = "10.1007/s00270-019-02205-w",
language = "English",
volume = "42",
pages = "991--1000",
journal = "Cardiovascular and interventional radiology",
issn = "0174-1551",
publisher = "Springer",
number = "7",

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Firanescu, CE, de Vries, J, Lodder, P, Schoemaker, MC, Smeets, AJ, Donga, E, Juttmann, JR, Klazen, CAH, Elgersma, OEH, Jansen, FH, van der Horst, I, Blonk, M, Venmans, A & Lohle, PNM 2019, 'Percutaneous vertebroplasty is no risk factor for new vertebral fractures and protects against further height loss (VERTOS IV)' Cardiovascular and interventional radiology, vol. 42, no. 7, pp. 991-1000. https://doi.org/10.1007/s00270-019-02205-w

Percutaneous vertebroplasty is no risk factor for new vertebral fractures and protects against further height loss (VERTOS IV). / Firanescu, Cristina E.; de Vries, Jolanda; Lodder, Paul; Schoemaker, Marinus C.; Smeets, Albert J.; Donga, Esther; Juttmann, Job R.; Klazen, Caroline A. H.; Elgersma, Otto E. H.; Jansen, Frits H.; van der Horst, Irene; Blonk, Marion; Venmans, Alexander; Lohle, Paul N. M.

In: Cardiovascular and interventional radiology, Vol. 42, No. 7, 2019, p. 991-1000.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Percutaneous vertebroplasty is no risk factor for new vertebral fractures and protects against further height loss (VERTOS IV)

AU - Firanescu, Cristina E.

AU - de Vries, Jolanda

AU - Lodder, Paul

AU - Schoemaker, Marinus C.

AU - Smeets, Albert J.

AU - Donga, Esther

AU - Juttmann, Job R.

AU - Klazen, Caroline A. H.

AU - Elgersma, Otto E. H.

AU - Jansen, Frits H.

AU - van der Horst, Irene

AU - Blonk, Marion

AU - Venmans, Alexander

AU - Lohle, Paul N. M.

PY - 2019

Y1 - 2019

N2 - Background:Percutaneous vertebroplasty (PV) is an alternative option to treat pain after an osteoporotic vertebral compression fracture (OVCF). Controversy exists as to whether PV increases the risk of new OVCFs or prevents further vertebral height loss in treated levels. We assessed both during 1-year follow-up in patients with acute OVCF randomised to PV or a sham procedure.Mehods:VERTOS IV is a prospective, multicentre, randomised controlled trial comparing PV with sham therapy in 180 patients. NewOVCFs and further vertebral height loss were assessed at 3, 6, and 12 months.Results:After a median follow-up of 12 months (interquartile range (IQR) = 12-12) 31 new fractures were reported in 15 patients from the PV group and 28 new fractures in 19 patients from the sham group. The occurrence of new vertebral fractures did not significantly differ between the groups (χ2(1) = 0.83, p = 0.36, OR = .71, 95%CI = 0.33-1.50). There was no higher fracture risk of adjacent versus distant vertebrae. After sham procedure, further height loss of treated vertebrae occurred more frequently (7 patients (8%) in the PV group and 39 (45%) in the sham group (χ2(1) = 28.85, p < 0.001, OR = 9.84, 95%CI = 4.08-23.73)) and was more severe (p < .001) than after PV.Conclusions:The risk of further vertebral height loss is significantly lower after PV compared to a sham intervention, i.e. PV protectsagainst progressive vertebral height loss. In addition, PV does not increase the risk of new adjacent and distant OVCFs.

AB - Background:Percutaneous vertebroplasty (PV) is an alternative option to treat pain after an osteoporotic vertebral compression fracture (OVCF). Controversy exists as to whether PV increases the risk of new OVCFs or prevents further vertebral height loss in treated levels. We assessed both during 1-year follow-up in patients with acute OVCF randomised to PV or a sham procedure.Mehods:VERTOS IV is a prospective, multicentre, randomised controlled trial comparing PV with sham therapy in 180 patients. NewOVCFs and further vertebral height loss were assessed at 3, 6, and 12 months.Results:After a median follow-up of 12 months (interquartile range (IQR) = 12-12) 31 new fractures were reported in 15 patients from the PV group and 28 new fractures in 19 patients from the sham group. The occurrence of new vertebral fractures did not significantly differ between the groups (χ2(1) = 0.83, p = 0.36, OR = .71, 95%CI = 0.33-1.50). There was no higher fracture risk of adjacent versus distant vertebrae. After sham procedure, further height loss of treated vertebrae occurred more frequently (7 patients (8%) in the PV group and 39 (45%) in the sham group (χ2(1) = 28.85, p < 0.001, OR = 9.84, 95%CI = 4.08-23.73)) and was more severe (p < .001) than after PV.Conclusions:The risk of further vertebral height loss is significantly lower after PV compared to a sham intervention, i.e. PV protectsagainst progressive vertebral height loss. In addition, PV does not increase the risk of new adjacent and distant OVCFs.

KW - Osteoporotic percutaneous vertebroplasty (PV)

KW - Vertebral compression fracture (OVCF)

KW - Visual analogue scale (VAS)

KW - Polymethylmethacrylate (PMMA)

KW - VERTOS IV

KW - Randomised controlled trial (RCT)

KW - COMPRESSION FRACTURES

KW - RANDOMIZED-TRIAL

KW - KYPHOPLASTY

KW - MORTALITY

KW - SECONDARY

KW - MORBIDITY

U2 - 10.1007/s00270-019-02205-w

DO - 10.1007/s00270-019-02205-w

M3 - Article

VL - 42

SP - 991

EP - 1000

JO - Cardiovascular and interventional radiology

JF - Cardiovascular and interventional radiology

SN - 0174-1551

IS - 7

ER -