Vertebroplasty in the inpatient population

Abstract

Background and purpose: Vertebroplasty is frequently offered to patients hospitalized for refractory pain due to vertebral fractures, because it is assumed that the procedure will facilitate resolution of pain and a rapid hospital discharge. We report our experience with inpatient vertebroplasty, with attention to rapidity of discharge and relevant clinical parameters.

Methods: We retrospectively reviewed the duration of hospitalization in patients admitted with primary diagnoses of back pain or vertebral fracture who were treated with vertebroplasty. We cataloged outcomes in the form of verbal pain scales (graded 0-10), in-hospital medication use (graded 0-6), and posthospitalization medication use. Outcomes were assessed at baseline and at 1 week, 1 month, 6 months, 1 year, and 2 years postvertebroplasty.

Results: We identified 66 such patients who had a median total hospital stay of 6.0 days (range, 1-26 days). Median length of stay before and after vertebroplasty were 4.0 (range, 1-24 days) and 1.5 days (range, 0-7 days), respectively. Ten (15%) patients were discharged the day of vertebroplasty. By days 2 and 3, 33 (50%) and 48 (72.7%) of the 66 patients had been discharged. Patients who received vertebroplasty earlier in the course of hospitalization demonstrated greater decreases in medication strength by discharge (P = .045). There was significant improvement in all outcome measures by 1 week, with continued improvement at 1 and 6 months.

Conclusion: This study confirms that vertebroplasty facilitates a rapid hospital discharge as well as long-term improvement in patients admitted for refractory pain. Vertebroplasty administered earlier in hospitalization also leads to greater decreases in analgesic requirements.

Figures

Fig 1.

Graphic representation of the 101 vertebral levels treated in this inpatient population. The frequency of treated levels is bimodal with peaks near T8–T9 and L1.

Fig 2.

Graphic representation of mean pain scores throughout follow-up. There is significant improvement at 1 week, 1 month, and 6 months relative to the preceding time point. Improvement in pain scores persists to maximal follow-up (2 years).