Percutaneous Vertebroplasty is no Risk Factor for New Vertebral Fractures and Protects Against Further Height Loss (VERTOS IV)

Journal Article · Mon Jul 15 00:00:00 EDT 2019 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-019-02205-W· OSTI ID:22969220

Vries, Jolanda de ^[1]; Lodder, Paul ^[2]; Schoemaker, Marinus C.; Smeets, Albert J.; Donga, Esther; Juttmann, Job R. ^[1]; Klazen, Caroline A. H. ^[3]; Elgersma, Otto E. H. ^[4]; Jansen, Frits H.; Horst, Irene van der; Blonk, Marion ^[5]; Venmans, Alexander; Lohle, Paul N. M. ^[1]

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1. Elisabeth TweeSteden Hospital, Departments of Radiology and Internal Medicine (Netherlands)
2. Tilburg University, Department of Medical and Clinical Psychology (Netherlands)
3. Medisch Spectrum Twente, Department of Radiology (Netherlands)
4. Albert Schweitzer Hospital, Department of Radiology (Netherlands)
5. Catharina Hospital, Department of Radiology (Netherlands)

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. Methods: VERTOS IV is a prospective, multicentre, randomised controlled trial comparing PV with sham therapy in 180 patients. New OVCFs 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 (χ{sup 2}(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 (χ{sup 2}(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 protects against progressive vertebral height loss. In addition, PV does not increase the risk of new adjacent and distant OVCFs. Level of Evidence: Level 1a, therapeutic study. ClinicalTrials.gov number, NCT01200277.

• OSTI ID: 22969220
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 42, Issue 7; Other Information: Copyright (c) 2019 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BONE FRACTURES
COMPRESSION
PAIN
PATIENTS
PMMA
THERAPY
VERTEBRAE