SAT0374 Radiofrequency kyphoplasty versus conservative care: Results of treating vertebral body fractures. (23rd January 2014)

• Record Type: Journal Article
• Authors: Pflugmacher, R.; Bornemann, R.; Karius, T.; Otten, L.A.; Wirtz, D.C.
• Is Part Of: Annals of the rheumatic diseases. Volume 71(2012)Supplement 3
• Page Start: 598
• Page End: 598
• Publication Date: 2014-01-23
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2012-eular.3320
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: There is controversy about how to treat vertebral fractures. Conservative care is the default approach, despite lack of evidence. Radiofrequency kyphoplasty uses ultrahigh viscosity cement to restore spinal posture and stabilize the fracture. Objectives: The aims of this study were to compare radiofrequency kyphoplasty to conservative care and assess the usual algorithm of starting all patients on conservative care for 6 weeks before offering surgery. Methods: Elderly patients with painful osteoporotic vertebral compression fractures were all treated with 6 weeks of conservative care (analgesics, bracing, and physiotherapy). They were then offered the choice of continuing conservative care or crossing over to radiofrequency kyphoplasty, at 6 and 12 weeks. Clinical success was defined as: 1) VAS pain improvement ≥2, 2) final VAS pain ≤5, 3) no functional worsening on ODI. Results: After the initial 6 weeks of conservative care, only 1 of 65 patients met the criteria for clinical success, and median VAS improvement was 0. After 12 weeks of conservative care, only 5 of 38 patients met the criteria for clinical success, and median VAS improvement was 1. At the 6 week follow-up after radiofrequency kyphoplasty, 31 of 33 surgery patients met the criteria for clinical success, and median VAS improvement was 5. Conclusions: For the vast majority of patients, conservative care did not provide meaningful clinical improvement. By contrast, nearly all patients who underwent radiofrequency kyphoplasty had rapid substantial improvement. Surgery was clearly much more effective than conservative care and should be offered to patients much sooner. Disclosure of Interest: None Declared