To date there are no prospective, randomized trials evaluating PV published in the literature. However, Zoarski et al. presented a small prospective (nonrandomized) evaluation of the effectiveness of PV

Vertebral Body Image
Figure 14.13. CT scan of a patient who experienced paraplegia following ver-tebroplasty as a result of a large cement leak. The cement (stars) occupies a large amount of the spinal canal at the level of the CT scan and creates cord compression.

for relieving pain.51 This report utilized the MODEMS method to establish that 22 of 23 patients improved after PV and remained satisfied during the 15- to 18-month follow-up. Additionally, several retrospective series are available and uniformly report good pain relief and reduced requirements for analgesics following PV.'16,17,22,27,44 This is especially true of pain related to compression fractures produced by osteoporosis, where significant pain relief of between 80 and 90% has been observed. This pain relief is persistent with no reports of additional compression of vertebra previously treated with PV. Additional fractures at other levels remain a possibility and source of morbidity. If osteoporotic compression fracture occurs, every effort to minimize future bone loss medically should be made. Also, modifications in lifestyle should be attempted to minimize mechanical stress on the spine and thereby lessen the risk of additional fractures.

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