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Predictive factors for sustained pain after (sub)acute osteoporotic vertebral fractures: Combined results from the VERTOS II and VERTOS IV trial
Firanescu,Cristina E. Venmans,Alexander de Vries,Jolanda Lodder,Paul Schoemaker,Marinus C. Smeets,Albert J. Donga,Esther Juttmann,Job R. Schonenberg,Karen Klazen,Caroline A. H.
Firanescu,Cristina E.
Venmans,Alexander
de Vries,Jolanda
Lodder,Paul
Schoemaker,Marinus C.
Smeets,Albert J.
Donga,Esther
Juttmann,Job R.
Schonenberg,Karen
Klazen,Caroline A. H.
Abstract
Purpose Osteoporotic vertebral compression fractures are treated conservatively or in selected cases with percutaneous vertebroplasty (PV). The purpose of this retrospective analysis is to determine predictive factors for a high visual analogue scale (VAS) pain score after conservative, sham or PV and is based on previously published randomized trials. Methods The VERTOS II compared conservative versus PV, and VERTOS IV compared sham versus PV treatment. The conservative group received pain medication. The sham and PV group received subcutaneous lidocaine/bupivacaine. In addition, the PV group received cementation, which was simulated in the sham group. Nineteen different predictors of high (>= 5) versus low (< 5) VAS pain score at 12 months were investigated. Results 20.7% of patients in the PV group demonstrated a VAS >= 5 at the 12-month, compared to 40.1% in the conservative or sham group, with a significant difference (chi(2)(1) = 15.26, p < 0.0001, OR = 2.57, 95% CI = 1.59 to 4.15). In the subgroup analysis, we detected five predictors for the risk of high pain scores (VAS >= 5 after 12 months follow-up), namely: female, baseline VAS > 8, long-term baseline pain, mild/severe Genant and new fractures. Conclusions Statistically significant more patients had a high pain score at 12 months in the sham and conservative group when compared with the PV group. Five predictors were identified for sustained high local back pain, regardless of the received treatment. Patients with moderate fracture deformity were less likely to have high pain scores at 12 months if they received PV than if they had sham or conservative therapy.
Description
VERTOS 2 study was sponsored by ZonMw (Dutch organization for health care research and innovation of care), project number 945-06-351 and an unrestricted grant from COOK Medical (Bloomington, IN, USA). VERTOS 4 study was supported by Stryker (Grant No S-I-013).
Date
2022
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Publisher
Research Projects
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Keywords
Percutaneous vertebroplasty (PV), Osteoporotic vertebral compression fracture (OVCF), Visual analogue scale (VAS), Polymethylmethacrylate (PMMA), RANDOMIZED-TRIAL, VERTEBROPLASTY, EXPERIENCE
Citation
Firanescu, C E, Venmans, A, de Vries, J, Lodder, P, Schoemaker, M C, Smeets, A J, Donga, E, Juttmann, J R, Schonenberg, K, Klazen, C A H, Elgersma, O E H, Jansen, F H, Fransen, H, Hirsch, J A & Lohle, P N M 2022, 'Predictive factors for sustained pain after (sub)acute osteoporotic vertebral fractures : Combined results from the VERTOS II and VERTOS IV trial', Cardiovascular and interventional radiology, vol. 45, no. 9, pp. 1314-1321. https://doi.org/10.1007/s00270-022-03170-7
License
info:eu-repo/semantics/openAccess