Interventional techniques in managing persistent pain after vertebral augmentation procedures: a retrospective evaluation.

BACKGROUND Based on systematic reviews, it appears that at least 10% of patients may continue to suffer with residual or persistent pain after successful vertebral or sacral augmentation procedures. OBJECTIVE To report and evaluate the incidence and prevalence of different spinal injections in patients who received vertebroplasty, kyphoplasty, and sacroplasty procedures for both benign and malignant compression fractures. DESIGN A retrospective case review. METHODS Retrospective review of all cases of vertebroplasty, sacroplasty, and kyphoplasty performed in a 12-month period in a single outpatient setting of interventional radiology was conducted. RESULTS In a 12-month period starting from October 2005 to September 2006, 144 patients underwent cement augmentation procedures. Of the 144, 34 patients required a spinal injection procedure for residual or persistent pain within a 1-year period after the augmentation procedure. Twenty-four patients required epidural steroid injections, 6 patients required intercostal nerve blocks, 5 patients required trigger point injections, 5 patients required sacroiliac joint injections, and 1 patient required facet joint injections. Nine patients who required lumbar epidural steroid injections and all patients who required intercostal nerve blocks and had underwent a thoracic cement augmentation procedure. CONCLUSION A small proportion of patients undergoing percutaneous cement augmentation for vertebral compression fractures or sacral insufficiency fractures potentially require spinal injections to treat residual pain after the procedure.