Percutaneous vertebroplasty treatment for new fracture of adjacent thoracic and lumbar vertebra in middle-aged and old people

Objective:To investigate the essentiality,technical characteristics and clinical efficacy of the percutaneous vertebroplasty (PVP) treatment for new fracture of adjacent thoracic and lumbar vertebrae in middle-aged and old people who had already been treated by PVP.Methods:The second PVP treatment was used for 41 patients whose thoracic or lumbar vertebra had been treated by PVP for compression fracture.The operative procedure was carried out as routine.Bone cement was injected into the compressed vertebrae one by one under exact monitoring,Clinical efficacy was evaluated 1 week later.Results:41 patients with 46 fractured vertebrae all had received PVP,in which 39 patients with 40 vertebrae had been treated by PVP again,2 patients with 6 vertebrae had been treated 2~3 times.For 43 of 46 fractured vertebrae,the unilateral vertebral pedicle,and 3 through the bilateral vertebral pedicle.4.0~8.5ml bone cement was injected into the target vertebra,with an average of 5.5ml.13 vertebral marrow cavities were filled for the most part (28.3%);27 moderately (58.7%) and 6 only for a small part (13.0%).Obvious vertebral canal and vascular leakage and related complications did not happen,and a week later 13 patients' symptoms were relieved or disappeared (31.7%);25 patients got partial remission (61%);3 were less effective (7.3%),but obviously relieved 4 weeks later.Conclusion:PVP treatment is a safe and effective method for middle-aged and elderly patients with reproducibility thoracic vertebra and lumbar vertebrae compression fracture after their first PVP.But this operation should be carried out early by exact monitoring of ECG.Generally,osteoporotic vertebrae need not to receive preventive PVP treatment,however,systemic health education will be helpful to reduce the risk of reproducibility symptomatic vertebral fracture.