Abstract
In Chapter 1, an outline of the thesis is given. In Chapter 2 we concluded that most conservatively treated patients with VCFs had sufficient pain relief during the first 3 months. After one year a substantial proportion of patients still had disabling pain despite higher class pain medication used. There
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were no predictors for the development of chronic pain. In Chapter 3 we concluded that pulmonary PMMA embolism during PV is an infrequent complication without clinical sequelae. After one year, no pulmonary reaction is seen on CT. No definite relationship of PMMA emboli with injected cement volume could be established. In Chapter 4 we concluded that small and clinically silent PCE occurred in a quarter of patients treated with PV. Cement leakage into the azygos vein was the only risk factor.Over time, these small cement emboli remained inert without inflammatory pulmonary response. In Chapter 5 we concluded that perivertebral cement leaks during PV for osteoporotic vertebral compression fractures occurred frequently. Cement leakage occurred more frequently with higher injected volumes. All patients remained asymptomatic and late cement migration during follow-up did not occur. Standard post-procedural CT of the treated vertebral body in PV is not necessary. In Chapter 6 we concluded that for a substantial proportion of patients local anesthesia was not sufficient for pain reduction during PV. The severity of pain experienced by the patient is mostly not valued correctly by the operator. In Chapter 7 we concluded that clinical response of percutaneous vertebroplasty is not affected by differences in injected cement volume. There is no correlation between injected cement volume and fracture location, fracture severity and type of treated vertebra. In Chapter 8 we concluded that the incidence of new vertebral compression fractures was not different after PV compared with conservative therapy after 1 year follow-up. Only risk factor for new vertebral compression fractures was the number of vertebral compression fractures at baseline. PV contributed to preservation of stature by decreasing both incidence and severity of further height loss in treated vertebra.In Chapter 9 the results of the different aspects of percutaneous vertebroplasty are interpreted and discussed.
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