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 -