Prospective assessment of pain and functional status after vertebroplasty for treatment of vertebral compression fractures.

Background And Purpose: There has been no prospective evaluation of vertebroplasty using a validated instrument. We describe the pain and functional status of 72 patients before and after vertebroplasty, as prospectively evaluated by the Vertebral Compression Fracture Pain and Functional Disability Questionnaire.

Methods: Of 161 consecutive patients, 72 consented to participate in the study and self-completed the questionnaire prior to undergoing vertebroplasty. Differences in pain and distress before and after vertebroplasty, and between the first and second follow-up intervals, were evaluated. Mean scores for each of 24 activities of daily living (ADLs) were plotted at the baseline and first and second follow-up intervals.

Results: The mean (SD) patient age was 74 (10) years; 80% were female. On the 0 (no pain) to 10 (pain as bad as it could be) visual analog pain scale, patients reported significantly more pain, on average, before undergoing percutaneous vertebroplasty (PV) than at the first follow-up interval (mean 5.8 vs 3.5, p<0.001). The reduction in reported pain following vertebroplasty persisted at the second follow-up on both the visual analog and adjectival pain scales. Among the 24 ADLs, between 25% and 69% of patients reported a mean improvement of at least 1 level on the 5-point ADL scale, and between 14% and 55% reported a mean improvement of at least two levels. The majority of the improvement in reported functional status following vertebroplasty was sustained at the second follow-up interval.

Conclusion: PV resulted in substantial, lasting reduction in pain and improvement in ability to perform ADLs.