Percutaneous vertebroplasty in a series of myasthenic patients with steroid-induced symptomatic vertebral fractures.

Vertebral compression fractures (VFs) are observed in 30-50 % of patients affected by steroid-induced osteoporosis, with consequentially severe back pain and functional limitation. An alternative treatment to medical therapy for pain caused by recent VFs is percutaneous vertebroplasty (PVP). Patients were treated by PVP after careful selection, based on the presence of persistent pain not resolved by standard medical therapy, correlation between pain and level of the VF, and neuroradiological features. We performed PVP in 4 patients with generalized MG associated with recent steroid-induced symptomatic VFs. Relief from pain was very rapid, usually within 24 h, and retained at a 3-month evaluation. No severe complication or MG worsening were observed in the post-operative period. Although clinical indication for PVP is still controversial, in our experience PVP is a useful and safe tool to be considered in the management of recent steroid-induced symptomatic VFs in selected MG patients.