What are the predictors of clinical success after percutaneous
vertebroplasty for osteoporotic vertebral fractures?
Received: 28 November 2017 /Revised: 14 December 2017 /Accepted: 21 December 2017 /Published online: 9 February 2018
European Society of Radiology 2018
Objectives Osteoporotic vertebral fractures are responsible for acute pain and disability that may persist for more than 2 months.
We wanted to identify predicting factors for mid-term outcome after vertebroplasty.
Methods We included consecutive patients who underwent vertebroplasty for fragility fractures with persistent and intense pain
between January 2014–June 2016. Outcome was assessed by an independent clinician after 1 month using a standardized
questionnaire. Patients were classified as having either a favorable or a poor outcome. Presence of an intravertebral cleft and
bone oedema mean signal intensity was assessed by an independent radiologist blinded to the clinical data. Pre-intervention
clinical or radiological factors were analysed as predictors for outcome.
Results In the 78 included patients (females 71%, age 75 ± 8.3 years), 61.5% had a favourable outcome. When vertebroplasty
was performed within 2 months after fracture, the outcome was favourable in 19 patients (39.6%) and poor in five (16.7%;
estimate for favourable outcome: OR = 4.1, 95% CI 1.2–13.8, p = 0.021). Absence of intravertebral cleft on pre-intervention
imaging was also a predictor of favourable outcome (OR = 3.7, 95% CI 1.2–11.8, p = 0.024). On pre-intervention MRI, vertebral
body oedema intensity signal did not influence the outcome.
Conclusions In patients with persistent and intense pain after an osteoporotic vertebral fracture, early intervention and absence of
intravertebral cleft were predictors of favourable outcome at 1 month after vertebroplasty.
• Performing vertebroplasty within 2 months following a fragility fracture increases success rate.
• Presence of an intravertebral cleft at baseline is a predictor of poor mid-term outcome.
• A pre-intervention MRI should be performed to ascertain the indication of vertebroplasty.
CI Confidence interval
OR Odds ratio
SD Standard deviation
Osteoporotic vertebral fragility fractures are a common cause
of pain and disability. They have a negative impact on health-
related quality of life and are associated with increased mor-
tality [1–3]. They also represent a financial burden, which is
likely to increase with the increasing elderly population .
Electronic supplementary material The online version of this article
(https://doi.org/10.1007/s00330-017-5274-1) contains supplementary
material, which is available to authorized users.
* Thomas Funck-Brentano
Department of Rheumatology, AP-HP, Lariboisière Teaching
Hospital, F-75475 Paris, France
Department of Musculoskeletal Radiology, AP-HP, Lariboisière
Teaching Hospital, F-75475 Paris, France
BIOSCAR UMRS 1132, Université Paris Diderot, Sorbonne Paris
Cité, INSERM, F-75475 Paris, France
B2OA UMR 7052, Université Paris Diderot, Sorbonne Paris Cité,
CNRS, F-75475 Paris, France
European Radiology (2018) 28:2735–2742