Efficacy of percutaneous vertebroplasty for multiple synchronous and metachronous vertebral compression fractures

Background and Purpose: Limited data exists regarding the efficacy of percutaneous vertebroplasty for multiple synchronous and metachronous vertebral compression fractures. The purpose of this study was to evaluate whether the number of vertebral levels treated during percutaneous vertebroplasty procedures or the number of separate vertebroplasty procedures performed on a given patient affect clinical outcomes. Materials and Methods: We defined 3 patient populations in our retrospective study. Group 1 included 328 patients who underwent 1 single-level vertebroplasty procedure. Group 2 included 226 patients who underwent a single procedure in which 2 or more vertebral levels were treated. Group 3 included 101 patients who underwent 2 or more separate vertebroplasty procedures. Follow-up was performed between 1 week and 2 years postoperatively. Clinical outcomes were assessed through analysis of quantitative measurements of pre-and postoperative levels of pain with and without activity (0-10) as well as mobility improvement. The Kruskal-Wallis rank sum test was used to evaluate the differences among groups. Univariate and χ² analyses were performed to show the proportion of underlying diseases in each group. Results: Mean pain improvement with/without activity at 2-year follow-up was 5.8/3, 4.9/3.7, and 5.4/3.1 in groups 1, 2, and 3, respectively; and mean mobility improvement in 2-year follow-up was 0.67, 0.63, and 0.65 for groups 1, 2, and 3, respectively. Conclusions: There was no significant difference in pain relief and mobility improvement in patients treated for multiple synchronous or metachronous vertebral compression fractures in comparison with those treated for solitary isolated fractures.