The Therapeutic Benefit of Repeat Percutaneous Vertebroplasty at Previously Treated Vertebral Levels

American Journal of Neuroradiology

TABLE 1:

Patient characteristics

Patient (No.)	1	2	3	4	5	6
Sex	F	M	F	F	F	M
Age (y)	66	78	49	56	67	76
Re-treated level	L1	L2	T6	L1	T10	L1
Interoperative interval (days)	167	18	8	22	9	21
Approach
Initial treatment	L^*	B^†	L	L	L	L
Repeat treatment	R^‡	R	R	L	R	R
Amount PMMA (cc)
Initial treatment	3.5	15	5	1.1	1.2	3
Repeat treatment	1.5	5	1.5	2.5	3.5	1.2
Initial Treatment
Preoperative pain	10	10	10	10	7	10
Postoperative pain	0	5	0	0	3	3
Preoperative mobility	0	2	0	3	0	1
Postoperative mobility	0	1	0	0	0	0
Repeat treatment
Preoperative pain	10	10	10	10	10	10
Postoperative pain	8	1	2	0	4	6
Preoperative mobility	1	2	1	0	0	3
Postoperative mobility	0	1	0	0	0	0

Note.—Pain was assessed using an 11-point scale (0–10), with 0 representing no pain and 10 representing “most pain ever experienced.” Mobility was assessed using a 5-point scale as follows: 0, walking without assistance; 1, walking with assistance; 2, wheelchair bound; 3, restricted to sitting in bed; 4, restricted to lying flat in bed. Follow-up was obtained between 1 week and 1 month postoperatively.
* Left unilateral transpediculate approach.
† Bilateral transpediculate approach.
‡ Right unilateral transpediculate approach.

TABLE 2:

Findings in patients before repeat treatment, including those at physical examination and imaging

Patient (No.)	Findings at Physical Examination	Imaging Findings
1	Point tenderness over L1 spinous process	Increased uptake at L1 on bone scan
2	Point tenderness over L2 spinous process	Increased uptake at L2 on bone scan
3	Point tenderness over T6, T7 spinous processes	Increased compression of T6 on radiograph
4	Tenderness 4 inches lateral to L1 spinous process	Stable fracture with diffuse edema at L1 on MR image
5	Point tenderness over T10 spinous process	Increased radiotracer uptake at T10 on bone scan
6	Point tenderness over L1 spinous process	No evidence of new fracture on CT scan