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.
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.
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.
Description
Date
2019
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Volume Title
Publisher
Research Projects
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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
Citation
Firanescu, C E, de Vries, J, Lodder, P, Schoemaker, M C, Smeets, A J, Donga, E, Juttmann, J R, Klazen, C A H, Elgersma, O E H, Jansen, F H, van der Horst, I, Blonk, M, Venmans, A & Lohle, P N M 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