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Vertebroplasty in Osteoporotic Spine Fractures: A Quality of Life Assessment

Published online by Cambridge University Press:  02 December 2014

Krishna Kumar ,
A.K. Verma ,
Jefferson Wilson  and
Alika LaFontaine
Krishna Kumar*
Affiliation:
Department of Surgery, Section of Neurosurgery, Regina General Hospital, University of Saskatchewan, Regina, SK, Canada
A.K. Verma
Affiliation:
Department of Radiology, Regina General Hospital, University of Saskatchewan, Regina, SK, Canada
Jefferson Wilson
Affiliation:
Department of Surgery, Section of Neurosurgery, Regina General Hospital, University of Saskatchewan, Regina, SK, Canada
Alika LaFontaine
Affiliation:
Department of Surgery, Section of Neurosurgery, Regina General Hospital, University of Saskatchewan, Regina, SK, Canada
*
Medical office wing, Regina General Hospital, Regina, SK, Canada S4P 0W5
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Abstract:

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Objective:

Our goal was to perform a quantitative evaluation of the improvement in functional capacity, quality of life, mental function, reduction in drug intake and impact on hospital admissions after vertebroplasty in the treatment of osteoporotic compression fractures. The efficacy of vertebroplasty in relief of pain has been addressed in previous publications but the quantitative evaluation of improvement in quality of life has not been addressed before.

Methods:

This is a prospective study of 42 patients with 83 symptomatic vertebral fractures treated by vertebroplasty with a mean follow-up of 9.1 months. The outcome was measured by pre and postoperatively utilizing the Visual Analogue Scale, the Oswestry Disability Index, the Rolland Morris Scale for Back Pain and EuroQol-5D questionnaire (EQ-5D). The postoperative evaluations were performed at one week, one month, three month, and six month intervals thereafter.

Results:

In 34 out of 39 active patients, marked pain relief was noted (87%). The Visual Analogue Scale score improved from a mean preoperative score of 8.2 to a mean postoperative score of 2.9 (p=0.0000003) at one week follow up and 3.9 at the last follow-up. The Rolland Morris Scale for Back Pain showed a drop from a mean preoperative rating of 13 to a mean postoperative rating of 10, showing a 25% improvement (p= 0.0207). The Oswestry Disability Index preoperatively was 64.4 which improved to 43.8 postoperatively, showing a 32% improvement (p= 0.0207). The EQ-5D showed a mean preoperative index value of 0.097 and mean postoperative index value of 0.592 (p = 0.0000003). All p-values were determined by the Willcoxin sign-ranked test.

Conclusion:

Vertebroplasty is a safe and efficacious procedure with a resulting improvement in pain and quality of life.

Résumé:

RÉSUMÉ: Objectif:

Le but de cette étude était d’évaluer quantitativement l’amélioration fonctionnelle, la qualité de vie, la fonction mentale, la diminution de la prise de médicaments et l’impact sur l’hospitalisation chez les patients ayant subi une vertébroplastie pour traiter des fractures ostéoporotiques par compression. L’efficacité de la vertébroplastie pour le soulagement de la douleur a fait l’objet de publications antérieures, mais l’évaluation quantitative de l’amélioration de la qualité de vie n’a pas été étudiée.

Méthodes:

Il s’agit d’une étude prospective de 42 patients présentant 83 fractures vertébrales symptomatiques traitées par vertébroplastie. Le suivi moyen a été de 9,1 mois. Le résultat était évalué au moyen de l’échelle analogue visuelle (ÉAV), du questionnaire d’invalidité d’Oswestry (QIO), de l’échelle de Rolland-Morris (ÉRM) pour l’évaluation de la douleur et de l’échelle EQ-5D avant et après la chirurgie. Les évaluations postopératoires étaient effectuées après 1 semaine, 1 mois, 3 mois et aux 6 mois par la suite.

Résultats:

Chez 34 des 39 patients actifs, une diminution importante de la douleur a été notée (87%). Le score à l’ÉAV s’est amélioré, passant d’un score moyen avant la chirurgie de 8,2 à un score moyen après la chirurgie de 2,9 (p = 0,0000003) à 1 semaine et à 3,9 au moment de la dernière évaluation du suivi. Le score à l’ÉRM a baissé, la moyenne étant de 13 avant la chirurgie et de 10 après, soit une amélioration de 25% (p = 0,0207). Le score au QIO était de 64,4 avant la chirurgie et de 43,8 après, soit une amélioration de 32% (p = 0,0207). Le score moyen au questionnaire EQ-5D était de 0,097 avant la chirurgie et de 0,592 après (p = 0,0000003). Toutes les valeurs de p ont été obtenues au moyen du test de la somme des rangs de Wilcoxon.

Conclusion:

La vertébroplastie est une intervention sûre et efficace qui procure une amélioration de la douleur et de la qualité de vie.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 32 , Issue 4 , November 2005 , pp. 487 - 495
Copyright
Copyright © The Canadian Journal of Neurological 2005

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