Added value of percutaneous vertebroplasty: effects on respiratory function.

Abstract

The objective of our study was to investigate the effects of percutaneous vertebroplasty on respiratory function in patients with compression fractures caused by osteoporosis. Ninety-eight patients (87 women, 11 men; mean age, 74 years; age range, 60-90 years) with compression fractures of 75 thoracic (Th7-Th12) and 89 lumbar (L1-L5) vertebrae were enrolled in this study. Percentage vital capacity (VC%), percentage forced vital capacity (FVC%), and percentage forced expiratory volume in 1 second (%FEV1) were measured using a spirometer before, 1 day after, and 1 month after percutaneous vertebroplasty. The Wilcoxon signed rank test was used to evaluate whether any significant differences in VC%, FVC%, or %FEV1 values existed between before, 1 day after, and 1 month after percutaneous vertebroplasty. The VC% and FVC% values had improved significantly by 1 month after percutaneous vertebroplasty compared with before percutaneous vertebroplasty (p<0.01). No significant difference was noted between values before and 1 day after percutaneous vertebroplasty. Likewise, no significant difference was identified in %FEV1 before percutaneous vertebroplasty and either 1 day or 1 month after percutaneous vertebroplasty. The mean degree of improvement in VC% values after percutaneous vertebroplasty for patients with one vertebra treated, which we refer to as the "single-vertebroplasty" group, and for patients with two or more vertebrae treated, or "multiple-vertebroplasty" group, was 1.1%±7% (SD) and 6.3%±8%, respectively, representing a significant difference between groups (p=0.01). The mean VC% values before and 1 month after percutaneous vertebroplasty differed significantly (p=0.02) in the thoracic group and overlapping group. Percutaneous vertebroplasty improves restrictive ventilatory impairment, but this improvement requires approximately 1 month to occur. Greater improvement in restrictive ventilatory dysfunction was observed in patients who underwent multiple vertebroplasty procedures than those who underwent a single procedure and in patients who underwent treatment of thoracic vertebrae than those who underwent treatment of other vertebrae.