Abstract
Introduction
Osteoporotic vertebral compression fractures (VCF) affect ~20% of postmenopausal women and can lead to long-term disability. Percutaneous Vertebroplasty (PVP) is a minimally invasive procedure, primarily used in patients with severe pain after VCF. Even with a thorough clinical examination, MRI scans and blood samples, some fractures maybe caused by an underlying malignant disease. Objectives were to determine the prevalence of malignancy and histology in bone biopsies obtained during PVP for osteoporotic VCF.
Material and Methods
Study design - Retrospective study of a prospective collected cohort. 144 consecutive patients underwent PVP for painful VCF, at the Center for Spine Surgery and Research, Middelfart Hospital. All patients had bone biopsies obtained during the PVP, and these biopsies were sent to the Department for Pathology at Vejle Sygehus for histologic diagnosis.
Results
144 patients were included in this study. The majority of the biopsy specimens (137, 95,1%) were acceptable for histological diagnosis. 129 (89.6%) of the biopsies showed no signs of malignancy. Seven (4,9%) were positive for malignancy. 1 biopsy was positive for MGUS. Seven (4.9%) of the biopsies were unsuitable for histologic diagnosis.
Conclusion
Our study shows a prevalence of unsuspected malignancy in biopsies during PVP of 4.9%. Conservative treatment with analgesics and brace can potentially delay diagnosis and treatment of underlying malignant disease. We recommend biopsy during PVP as a standard-procedure, to insure not to overlook any underlying malignancy despite the MRI-scan, blood analysis and clinical examination being inconspicuous.