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Response of Nonmidline Pain to Percutaneous Vertebroplasty

¹ Department of Internal Medicine, Barnes-Jewish Hospital, St. Louis, MO.
² Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd., St. Louis, MO 63110.

OBJECTIVE. The purpose of this study was to determine the prevalence of nonmidline symptoms in patients undergoing percutaneous vertebroplasty and the response of these symptoms to vertebroplasty.

MATERIALS AND METHODS. This is a retrospective study performed through examination of patient records, baseline questionnaires, demographic sheets, follow-up questionnaires, reports from telephone follow-up, and pain location diagrams completed before and after percutaneous vertebroplasty. Data were gathered from 350 patient encounters, 686 vertebroplasty procedures, and 288 patients. After determining the prevalence of nonmidline pain, analysis of acquired data was performed to determine the efficacy of vertebroplasty in relieving nonmidline pain.

RESULTS. Nonmidline pain was present in 240 of 350 patient encounters. Major symptom areas were the ribs; hip, groin, and buttocks; and legs and thighs. Lesser areas of nonmidline symptoms were the abdomen, shoulders, and waistline. Overall there was improvement in nonmidline pain in 83% of the procedures.

CONCLUSION. Most patients presenting for percutaneous vertebroplasty have nonmidline pain. Vertebroplasty reduced or eliminated nonmidline pain in 76-92% of the patients in whom it was reported. Procedures involving lumbar vertebrae tended to be successful less often than others, but even in these patients the procedure was successful in approximately 75%.

Keywords: fracture • nonmidline pain • osteoporosis • percutaneous vertebroplasty • spine • vertebroplasty

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