LAUSR

OBJECTIVE This study aimed to compare clinical functional outcomes and new vertebral compression fractures (NVCFs) between percutaneous vertebroplasty (PVP) and conservative treatment (CT) in patients with severe pain due to acute osteoporotic vertebral compression fractures (OVCFs). PVP is increasingly used for treatment of pain in patients with OVCFs, but the effectiveness of the procedure and whether it causes NVCFs remain controversial. METHODS A total of 544 eligible patients with OVCFs on spine radiography and intractable back pain for≤6weeks were recruited between September 2012 and February 2018, and assigned to the PVP (n=280; 392 levels) and CT (n=264; 366 levels), respectively, according to treatment regimen. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores were determined pre-intervention and at various follow up times, including 1 week, and 1, 3, 6, 12 and 24 months, respectively. In addition, monthly telephone follow-ups were performed. In case of sudden increase in back pain, the patient was asked to return to the hospital for medical and MRI examinations for NVCF detection. RESULTS Significantly lower VAS and ODI scores were obtained in the PVP group compared with the CT group at 1 week, and 1,3 and 6months (p<0.05); differences after 6 months were non-significant (p>0.05). Similar numbers of NVCFs (total and adjacent fractures) were obtained at 24 months in both groups(p>0.05). CONCLUSION Compared with CT, PVP provides a rapid decrease of pain and an early return to daily life activities, while not increasing the incidence of NVCFs.