Histologic Changes After Vertebroplasty

Verlaan, Jorrit Jan; Öner, F. Cumhur; Slootweg, Piet J.; Verbout, Abraham J.; Dhert, W.J.A.

doi:10.2106/00004623-200406000-00016

Cited by 75 publications

(57 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Greater nutritional demands may make these discs more vulnerable to changes in nutrition supply, possibly leading to more positive results. Previous studies reporting that injury to the endplates results in IDD in an immature model [17], but not in a mature animal model [13], supports to some extent the notion that the immature model is sensitive to interference in the nutritional pathway.…”

Section: Resultsmentioning

confidence: 66%

“…After unilaterally blocking endplates in an adult dog model, Hutton, et al [12] did not find any visible IDD, but found slightly abnormal histological changes. After unilaterally blocking, and even breaking, endplates in a mature goat model, Verlaan et al [13] did not find histological evidence for IDD. This negative result might be attributable to the fact that the other side of the endplate pathway continued to provide adequate nutrition.…”

Section: Resultsmentioning

confidence: 95%

“…Blocking the endplate nutritional pathway with bone cement for a certain period (several months to 1.5 years) produced no obvious IDD in several adult animal models [11][12][13]. Interfering in the endplate pathway does not seem to affect the health of adjacent discs in mature animal models.…”

Section: Introductionmentioning

confidence: 96%

See 2 more Smart Citations

Interference in the endplate nutritional pathway causes intervertebral disc degeneration in an immature porcine model

Kang

Ringgaard

et al. 2014

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose Previous studies have shown that blocking the endplate nutritional pathway with bone cement did not result in obvious intervertebral disc degeneration (IDD) in mature animal models. However, there are very few comparable studies in immature animal models. As vertebroplasty currently is beginning to be applied in young, even biologically immature patients, it is important to investigate the effect of cement blocking at the endplate in an immature animal model. Methods Two lumbar intervertebral discs in eight immature pigs were either blocked by cement in both endplate pathways or stabbed with a scalpel in the annulus fibrosus (AF) as a positive control, and with a third disc remaining intact as a normal control. Magnetic resonance imaging (MRI) and histology study were performed. Results After three months, the cement-blocked discs exhibited severe IDD, with the percentage of disc-height index (DHI), nucleus pulposus (NP) area, and NP T2 value significantly lower than the normal control. These IDD changes were histologically confirmed. Post-contrast MRI showed diseased nutritional diffusion patterns in the cement-blocked discs. Moreover, the degenerative changes of the cementblocked discs exceeded those of the injured AF positive controls.Conclusions The endplate nutritional pathway was interfered with and diseased after three months of bone cement intervention in an immature porcine model. Severe interference in the endplate nutritional pathway in an immature porcine model caused IDD. These findings also draw attention to the fact that interference in endplate nutritional pathways in immature or young patients may affect the vitality of adjacent discs.

show abstract

Section: Resultsmentioning

confidence: 66%

Section: Resultsmentioning

confidence: 95%

See 1 more Smart Citation

Interference in the endplate nutritional pathway causes intervertebral disc degeneration in an immature porcine model

Kang

Ringgaard

et al. 2014

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…It was concluded in one of the studies by Verlaan et al that anterior column augmentation by transpedicular balloon vertebroplasty with calcium phosphate cement (CPC) injection was safe and feasible [42]. Although both cements were suggested to be suitable vertebral bone void fillers, CPC showed superior biocompatibility, since the polymethyl methacrylate cement sometimes provoked a mild inflammatory reaction in the surrounding tissue [24,25,41]. The purpose of the present study was to demonstrate the feasibility and safety of balloon vertebroplasty with poly methylmethacrylate, in addition to posterior short-segment reduction and fixation in 16 patients with traumatic lumbar burst fractures.…”

Section: Introductionmentioning

confidence: 99%

Short segment pedicle screw instrumentation and augmentation vertebroplasty in lumbar burst fractures: an experience

Afzal¹,

Saleem²,

Dhar³

2008

Eur Spine J

View full text Add to dashboard Cite

To assess the efficacy and feasibility of vertebroplasty and posterior short-segment pedicle screw fixation for the treatment of traumatic lumbar burst fractures. Short-segment pedicle screw instrumentation is a well described technique to reduce and stabilize thoracic and lumbar spine fractures. It is relatively a easy procedure but can only indirectly reduce a fractured vertebral body, and the means of augmenting the anterior column are limited. Hardware failure and a loss of reduction are recognized complications caused by insufficient anterior column support. Patients with traumatic lumbar burst fractures without neurologic deficits were included. After a short segment posterior reduction and fixation, bilateral transpedicular reduction of the endplate was performed using a balloon, and polymethyl methacrylate cement was injected. Pre-operative and post-operative central and anterior heights were assessed with radiographs and MRI. Sixteen patients underwent this procedure, and a substantial reduction of the endplates could be achieved with the technique. All patients recovered uneventfully, and the neurologic examination revealed no deficits. The postoperative radiographs and magnetic resonance images demonstrated a good fracture reduction and filling of the bone defect without unwarranted bone displacement. The central and anterior height of the vertebral body could be restored to 72 and 82% of the estimated intact height, respectively. Complications were cement leakage in three cases without clinical implications and one superficial wound infection. Posterior short-segment pedicle fixation in conjunction with balloon vertebroplasty seems to be a feasible option in the management of lumbar burst fractures, thereby addressing all the three columns through a single approach. Although cement leakage occurred but had no clinical consequences or neurological deficit.

show abstract

“…A compressive strength of 30 MPa is reached at 6 h and 60 MPa at 3 days [24,35]. A biologic improved osteotransduction capacity after 6 months without cellular toxicity or mutation was confirmed in animal study [25,26,27,28,34]. …”

Section: Introductionmentioning

confidence: 92%

Prospective study of standalone balloon kyphoplasty with calcium phosphate cement augmentation in traumatic fractures

Maestretti¹,

Cremer²,

Otten

et al. 2006

Eur Spine J

160

View full text Add to dashboard Cite

Prospective consecutive series cases study to investigate the clinical and radiological results of standalone balloon kyphoplasty and cement augmentation with calcium phosphate in traumatic fractures. Independent observer evaluation of radiological and computer tomography results, visual analogue scale (VAS), Roland-Morris score and complications with acute traumatic compression fractures type A, treated with a standalone balloon kyphoplasty and cement augmentation with calcium phosphate (Calcibon TM ); follow-up time at a mean of 30 months (24-37 months). From August 2002 to August 2003, consecutive patients with traumatic compression fractures (Magerl type A) without neurological deficit underwent standalone kyphoplasty with Calcibon. We report here the pre-, post-operative and the followup results, applying the VAS (0-10) for pain rating, the Roland-Morris (0-24) disability score, CT-scan examination, detailed radiographic evaluation of vertebral body (VB) deformity and segmental kyphosis measurement. The pre-operative X-ray measurements, VAS and the 7 days Roland-Morris scores are compared with the post-operative and the 30 months follow-up findings. Twenty-eight patients with 33 treated fracture levels were included in this study. The mean initial vertebral deformity (VB kyphosis) was 17°, corrected to a post-operative of 6°. We noted a loss of correction at the follow-up in comparison to the post-operative standing X-ray at 24 h of 3°ver-tebral deformity and 3°segmental kyphosis. The VAS score demonstrates a decrease over time from a mean of 8.7-3.1 at 7 days and to 0.8 at the last follow-up. The Roland-Morris disability score demonstrates a similar improvement. We noticed no major complications related to the procedure. The mean cement resorption after 1 year was 20.3% (0.3-35.3%) and is related to the individual biological resorption process and is not predictable. All patients with vertebral fractures as sole medical problem were discharged within 48 h. All active patients returned to the same work within 3 months with the same working ability as before the accident. Standalone balloon kyphoplasty is a potential alternative mini-invasive technique to reduce the fractures. However, due to the intrinsic characteristic of calcium phosphate cement (Calcibon) we recommend the application of this biological cement for standalone reduction and stabilisation only in fractures type A1 and A3.1 in young patient. In case of higher destruction levels of the VB, we propose the utilisation of Calcibon associated with posterior instrumentation. Having regard to the pointed out indications, our preliminary results demonstrate a new possibility to treat this kind of fractures, allowing a rapid handling of pain, early discharge and return to normal activities.

show abstract

Histologic Changes After Vertebroplasty

Cited by 75 publications

References 40 publications

Interference in the endplate nutritional pathway causes intervertebral disc degeneration in an immature porcine model

Interference in the endplate nutritional pathway causes intervertebral disc degeneration in an immature porcine model

Short segment pedicle screw instrumentation and augmentation vertebroplasty in lumbar burst fractures: an experience

Prospective study of standalone balloon kyphoplasty with calcium phosphate cement augmentation in traumatic fractures

Contact Info

Product

Resources

About