» Articles » PMID: 22116114

Natural History of Pain in Patients with Conservatively Treated Osteoporotic Vertebral Compression Fractures: Results from VERTOS II

Overview
Specialty Neurology
Date 2011 Nov 26
PMID 22116114
Citations 34
Authors
Affiliations
Soon will be listed here.
Abstract

Background And Purpose: We analyzed the natural course of conservatively treated osteoporotic vertebral compression fractures from VERTOS II, a randomized trial of vertebroplasty and conservative therapy in 202 patients with vertebral compression fractures. We assessed the proportion of patients who developed chronic back pain and possible risk factors.

Materials And Methods: In VERTOS II, the VAS score was assessed at regular intervals until 1 year follow-up. We followed 95 conservatively treated patients until sufficient pain relief, defined as a VAS score ≤3. These patients were censured at the involved follow-up interval. In addition, baseline clinical and imaging data, and class of pain medication used in patients with a VAS score ≤3 at any follow-up interval were compared with those in patients with a VAS score >3 at every follow-up by using logistic regression analysis.

Results: During 1 year of follow-up, 57 of 95 patients (60%) had sufficient pain relief with VAS scores ≤3. Thirty-eight patients (40%) still had pain with VAS-scores ≥4 at the last follow-up interval of 12 months, despite the use of higher class pain medication. Statistical analysis showed no risk factors.

Conclusions: In the VERTOS II trial, most conservatively treated patients with acute osteoporotic compression fractures had sufficient pain relief during the first 3 months. However, after 1 year, a substantial proportion of patients still had disabling pain despite higher class pain medication used. There were no predictors for the development of chronic pain. Patients with continuing pain ≥3 months after the fracture may be candidates for vertebroplasty.

Citing Articles

Percutaneous Transpedicular Intravertebral Cage Augmentation with Short-Segment Fixation Using Specially Designed Cannulated Cage Trials for Advanced Kümmell Disease: A Preliminary Study Comparing with Vertebroplasty with Short-Segment Fixation.

Park S, Cheh G, Kim Y, Chung H, Kang M, Choi J Clin Orthop Surg. 2025; 17(1):29-38.

PMID: 39912073 PMC: 11791496. DOI: 10.4055/cios24276.


A novel treatment option for Kummell's disease using percutaneous kyphoplasty with a mesh-hold bone filling container.

Mao B, Wang W, Wang Q, Li L Sci Rep. 2024; 14(1):29069.

PMID: 39580562 PMC: 11585556. DOI: 10.1038/s41598-024-80890-5.


The surgical strategy selection and clinical efficacy analysis of Kummell's disease.

Lin Y, Chen Z, Zhang Q, Qiu J, Zhang X, Cao P Eur Spine J. 2024; 33(12):4488-4498.

PMID: 39343794 DOI: 10.1007/s00586-024-08469-2.


Effect of electrode attachment location for transcutaneous electrical nerve stimulation for pain relief in lumbar vertebral body fractures.

Hara K, Yoshida H, Tanaka D J Phys Ther Sci. 2024; 36(8):415-419.

PMID: 39092416 PMC: 11290860. DOI: 10.1589/jpts.36.415.


Mortality, Analgesic Use, and Care Requirements After Vertebral Compression Fractures: A Retrospective Cohort Study of 18,392 Older Adult Patients.

Honda A, Yamana H, Sasabuchi Y, Takasawa E, Mieda T, Tomomatsu Y J Bone Joint Surg Am. 2024; 106(16):1453-1460.

PMID: 38950100 PMC: 11594000. DOI: 10.2106/JBJS.23.01438.


References
1.
Klazen C, Lohle P, de Vries J, Jansen F, Tielbeek A, Blonk M . Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet. 2010; 376(9746):1085-92. DOI: 10.1016/S0140-6736(10)60954-3. View

2.
Ploeg W, Veldhuizen A, The B, Sietsma M . Percutaneous vertebroplasty as a treatment for osteoporotic vertebral compression fractures: a systematic review. Eur Spine J. 2006; 15(12):1749-58. DOI: 10.1007/s00586-006-0159-z. View

3.
Zoarski G, Snow P, Olan W, Stallmeyer M, Dick B, Hebel J . Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. J Vasc Interv Radiol. 2002; 13(2 Pt 1):139-48. DOI: 10.1016/s1051-0443(07)61930-7. View

4.
Legroux-Gerot I, Lormeau C, Boutry N, Cotten A, Duquesnoy B, Cortet B . Long-term follow-up of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Clin Rheumatol. 2004; 23(4):310-7. DOI: 10.1007/s10067-004-0914-7. View

5.
McGraw J, Lippert J, Minkus K, Rami P, Davis T, Budzik R . Prospective evaluation of pain relief in 100 patients undergoing percutaneous vertebroplasty: results and follow-up. J Vasc Interv Radiol. 2002; 13(9 Pt 1):883-6. DOI: 10.1016/s1051-0443(07)61770-9. View