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Institute for Cancer Research and Treatment Candiolo (TURIN) - Italy

Long-Term Data for 884 Patients Show Vertebroplasty for Osteoporotic Spinal Fractures Provides Dramatic Pain Relief, Greatly Decreases Disability. Giovanni Carlo ANSELMETTI, MD. Institute for Cancer Research and Treatment Candiolo (TURIN) - Italy. Percutaneous Vertebroplasty STUDY DESIGN.

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Institute for Cancer Research and Treatment Candiolo (TURIN) - Italy

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  1. Long-Term Data for 884 Patients Show Vertebroplasty for Osteoporotic Spinal Fractures Provides Dramatic Pain Relief, Greatly Decreases Disability Giovanni Carlo ANSELMETTI, MD Institute for Cancer Research and Treatment Candiolo (TURIN) - Italy

  2. Percutaneous VertebroplastySTUDY DESIGN We prospectively evaluated back-pain improvement, new fracture rate and complications in a large series of Osteoporotic Patients underwent to Percutaneous Vertebroplasty for vertebral fracture refractory to conservative medical treatment

  3. Patients Populations884 Patients(750 female - 134 male mean age 73,1 years) • 639Primary Osteoporosis (72,3%) • 245Secondary to Steroidal therapy (27,7%) • Treated on 3954Vertebrae • All procedures in Local anesthesia • Patients discharged from the Hospital the same procedural day

  4. Clinical Evaluation • Pain was evaluatedusing a 11-point Visual Analogic Scale from 0 (no pain) to 10 (worst experienced pain)before and after the procedure. • Disability improvement was evaluated by external Brace support and Oswestry Disability Questionnaire before and after Vertebroplasty • If patients reported back-pain recurrence during follow-up clinical interview and MRI were performed to investigate new vertebral fracture

  5. Visual Analog Scale Pre e Post VTP884 patientsFollow-up up to 52 months P<0.0001 Wilcoxon signed rank Test SD±1,5 SD±1,8 845/884 patients(95,6%)reported backpain improvement

  6. Quality of Life after PVBrace supportFollow-up up to 52 months P<0.0001 McNemar’s Test

  7. Quality of Life Oswestry Disability Questionnaire884 Pts P<0.0001 Paired t test SD ±13,5% SD±6,9%

  8. New Fractures in Osteoporosis884 Patients - Follow-up up to 52 months During follow-up all patients were invited to contact us whenever backpain occurred again after PV. MR and plain radiograms showed a new vertebral fractures in: 106 patients (12%) Occurred 15 days to 36 months(mean 9,4±8,7 months) after previous Vertebroplasty They were all successfully retreated!

  9. New Fractures in OsteoporosisFracture on Contiguous vertebra73/106 patients (68,9%)

  10. RETREATMENTS in OsteoporosisNew Fracture during 18 months Follow-upVertebroplasty vs. Placebo & Teriparatide

  11. COMPLICATIONS18/884 patients (2%) • 12 (1,4%) asymptomatic pulmonary embolism • 6 (0,7%) nerve root irritation successfully treated by local steroidal injection Vertebroplasty was completed in all patients without any major complications

  12. CONCLUSIONS • Vertebroplasty is safe and effective in the treatment of back-pain due to osteoporotic vertebral collapses. • After Vertebroplasty patients can increase mobility and improve their quality of life. • New fracture rate seems to be similar to not PV-treated osteoporotic pts reported by literature. • Our data suggest that Vertebroplasty should always be proposed to patients when conservative medical treatment fails.

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