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Abstract

Percutaneous Vertebroplasty Versus Conservative Treatment and Rehabilitation in Women with Vertebral Fractures due to Osteoporosis: A Prospective Comparative Study

VOLUME 67 - NUMBER 2 / March-April (Original articles)

Salvador Israel Macías-Hernández, Department of Osteoarticular Rehabilitation, Instituto Nacional de Rehabilitación, México D.F., Mexico
Daniel David Chávez-Arias, Subdivision of Medicine, Instituto Nacional de Rehabilitación, México D.F., Mexico
Antonio Miranda-Duarte, Departments of Genomic Medicine, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
Roberto Coronado-Zarco, Department of Orthopedic Rehabilitation, Instituto Nacional de Rehabilitación, México D.F., Mexico
María del Pilar Diez-García, Osteoporosis Clinic, Instituto Nacional de Rehabilitación, México D.F., Mexico

Background: Percutaneous vertebroplasty is commonly used in the management of osteoporosis-related vertebral fractures, although there is controversy on its superiority over conservative treatment. Here we compare pain and function in women with vertebral osteoporotic fractures who underwent percutaneous vertebroplasty versus conservative treatment with a protocolized rehabilitation program. Methods: A longitudinal and comparative prospective study was conducted. Women ≥ 60 years of age with a diagnosis of osteoporosis who had at least one vertebral thoracic or lumbar compression fracture were included and divided into two groups, conservative treatment or vertebroplasty. The Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were used to assess pain and function, respectively, as the outcome measures. Results: We included 31 patients, 13 (42%) treated with percutaneous vertebroplasty and 18 (58%) with conservative treatment. Baseline clinical characteristics, bone densitometry and fracture data were similar in both groups. At baseline, VAS was 73.1 ± 28.36 in the vertebroplasty group and 68.6 ± 36.1 mm in the conservative treatment group (p = 0.632); at three months it was 33.11 ± 10.1 vs. 42 ± 22.21 mm (p = 0.111); and at 12 months, 32.3 v 11.21 vs. 36.1 v 12.36 mm (p = 0.821). The ODI at baseline was 83% in the vertebroplasty group vs. 85% for conservative management (p = 0.34); at three months, 36 vs. 39% (p = 0.36); and at 12 months, 29.38 vs. 28.33% (p = 0.66). Conclusions: Treatment with percutaneous vertebroplasty had no advantages over conservative treatment for pain and function in this group of women ≥ 60 years of age with osteoporosis.

Keywords: Rehabilitation. Vertebroplasty. Spinal fracture. Osteoporosis. Therapeutics.

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