Vertebroplasty: pros and cons in treating vertebral compression fractures

Background: Vertebroplasty is a minimally invasive procedure for the treatment of vertebral compression fractures.
Objective: To assess the advantages and disadvantages of vertebroplasty.
Methodology: this study is an interventional prospective study includes 20 patients who treated with vertebroplasty in Al-Azhar University hospitals and Mansoura new general hospital, during 2018 and 2019.
Results: In our study vertebroplasty was effective in reducing pain in most of patients within a short period of time. Preoperative visual analog scale (VAS) ranged from 7 to 9 and the mean was 8.4± 0.699 and Postoperative VAS ranged from 1 to 7 and the mean was 2.3±1.88. The height restoration ranges from 0.5% to 28% of the relative vertebral body height & by a mean of 5.14% (SD±8.14%). The local kyphotic angle improved by a mean of 2.21° (SD±1.5). We had no anesthetic complications and 50% of our cases was done under local anesthetics and the other were under general anesthesia. We had no cases of spinal infection. Vertebroplasty cement leakage: the incidence was 30% (6 cases). Intradiscal cement leakage was 5% (1 case). Prevertebral cement leakage was 10% (4 case). Their ware no vascular cement leakage. The incidence of canal and foraminal cement leakage was 5% (1 case) which required decompressive laminectomy and foramenotomy.
Conclusion: Vertebroplasty was found to be beneficial in treating painful vertebral collapse by lowering pain, raising vertebral body height, and correcting local vertebral kyphosis in a short amount of time. And, with careful patient selection, it might be done under local anesthetics. The incidence of symptomatic complications after vertebroplasty is rare such as: cement leakage which can lead to permanent neurological deficits or vascular and pulmonary embolism, adjacent level vertebral fracture and infection. To get the greatest outcomes and avoid complications, adequate patient selection, pre-procedural evaluation, and proper technique should be used.