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Reidy, Declan; Ahn, Henry; Mousavi, Payam; Finkelstein, Joel; Whyne, Cari

doi:10.1097/00007632-200307150-00011

Cited by 6 publications

(8 citation statements)

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“…The higher risk of extravasation in patients with spinal malignancy, compared with patients with osteoporotic vertebrae, may be attributed to the increased in situ pressures generated during the procedure [33]. Injection of bone cement into a vertebral body with a resident tumor is more difficult than injection into an osteoporotic vertebral body.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Selective Vertebroplasty: State of the Art Management in Well-Confined Metastatic Vertebral Lesions

Elnoamany

2016

Asian Spine J

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Study DesignProspective cohort study.PurposeTo evaluate the clinical and radiological results of percutaneous selective vertebroplasty (PSV) as first-line treatment options in the setting of well-confined spinal metastases.Overview of LiteratureRecent technological advances combined with innovative interventional techniques enable an alternative less invasive treatment option for many patients with malignant vertebral body infiltration. Percutaneous vertebral augmentation procedures offer less invasive but effective pain relief to many patients with symptomatic spinal metastatic disease.MethodsEleven patients with 21 well-confined metastatic vertebral lesions that had been treated with PSV were included. Pain was evaluated one week, one month, 3 months and 6 months post-procedure using a 10-point visual analogue scale (VAS). A statistical analysis including repeated measures analysis of variance test was used to collectively indicate the presence of any significant differences between different time sequences. Medication usage and range of mobility were also evaluated.ResultsThe 11 patients had an average age of 42 years and 54.5% were male. Highly significant improvements in VAS scores at rest and with activity (p<0.001) were evident. There was a significant decrease in rate of medication consumption post-procedure (p<0.05).ConclusionsPSV can be used successfully as the first-line treatment for well-confined metastatic vertebral lesions. It is also an effective method to decrease pain, increase mobility, and decrease narcotic administration in such patients.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Selective Vertebroplasty: State of the Art Management in Well-Confined Metastatic Vertebral Lesions

Elnoamany

2016

Asian Spine J

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“…A previous study has elaborated that metastases led to the decrease of hydraulic permeability of the vertebral body on the account of a relatively higher viscosity of tumor tissue as compared with the bone marrow, which generated higher intravertebral pressure during cement injection [ 17 ]. The creation of a void replaces tumor tissue with space and reduces the effect of tumor tissue on the hydraulic permeability of the vertebral body.…”

Section: Discussionmentioning

confidence: 99%

“…In brief, bone extravasation depended on cement viscosity and bone structure. Weisskopf et al [ 29 ] and Reidy et al [ 17 ] revealed that no correlation between intravertebral pressure development and cement extravasation could be established. However, when bone cement augments a specific region in the vertebral body, it is required to extrude the tumor tissue out of the region of metastases.…”

Section: Discussionmentioning

confidence: 99%

“…Then, the hole in the lateral wall of vertebral body was sealed with polymethylmethacrylate bone cement. The bone density of each vertebra was determined by the dry weight and trabecular size of the removed bone core, a methodology previously described by Reidy et al [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

“…Other complications include embolisms due to the bone marrow, tumor fragments, or bone cement. The presence of tumor tissue in the vertebral body contributes to a higher intravertebral pressure and unsatisfactory cement distribution [ 17 ]. It is necessary to explore a method to reduce the adverse effects of tumor tissue and investigate the underlying basis of the method in vertebroplasty.…”

Section: Introductionmentioning

confidence: 99%

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The effect of void creation prior to vertebroplasty on intravertebral pressure and cement distribution in cadaveric spines with simulated metastases

Jiang

et al. 2015

Journal of Orthopaedic Surgery and Research

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BackgroundFor osteoporosis or spinal metastases, percutaneous vertebroplasty is effective in pain relief and improvement of mobility. However, the complication rate (cement extravasation and fat embolisms) is relatively higher in the treatment of spinal metastases. The presence of tumor tissue plays a significant role in intravertebral pressure and cement distribution and thereby affects the occurrence of complications. We investigated the effect of void creation prior to vertebroplasty on intravertebral pressure and cement distribution in spinal metastases.MethodsEighteen vertebrae (T8–L4) from five cadaveric spines were randomly allocated for two groups (group with and without void) of nine vertebrae each. Defect was created by removing a central core of cancellous bone in the vertebral body and then filling it with 30% or 100% fresh muscle paste by volume to simulate void creation or no void creation, respectively. Then, 20% bone cement by volume of the vertebral body was injected into each specimen through a unipedicular approach at a rate of 3 mL/min. The gender of the donor, vertebral body size, bone density, cement volume, and intravertebral pressure were recorded. Then, computed tomography scans and cross sections were taken to evaluate the cement distribution in vertebral bodies.ResultsNo significant difference was found between the two groups in terms of the gender of the donor, vertebral body size, bone density, or bone cement volume. The average maximum intravertebral pressure in the group with void creation was significantly lower than that in the group without void creation (1.20 versus 5.09 kPa, P = 0.001). Especially during the filling of void, the difference was more pronounced. Void creation prior to vertebroplasty allowed the bone cement to infiltrate into the lytic defect.ConclusionsIn vertebroplasty for spinal metastases, void creation produced lower intravertebral pressure and facilitated cement filling. To reduce the occurrence of complication, it may be an alternative to eliminate the tumor tissue to create a void prior to cement injection.

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Arterial embolization during percutaneous vertebroplasty resulting in bilateral renal infarcts and ischemic colitis

Sidhu

Teh

2023

Skeletal Radiol

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Abstract: Percutaneous vertebroplasty produces higher intravertebral pressures in vertebrae containing a simulated lytic metastasis than in intact vertebrae. Pressures generated in the tumor specimens are sufficiently elevated to cause embolic phenomena.

Cited by 6 publications

References 0 publications

Percutaneous Selective Vertebroplasty: State of the Art Management in Well-Confined Metastatic Vertebral Lesions

Percutaneous Selective Vertebroplasty: State of the Art Management in Well-Confined Metastatic Vertebral Lesions

The effect of void creation prior to vertebroplasty on intravertebral pressure and cement distribution in cadaveric spines with simulated metastases

Arterial embolization during percutaneous vertebroplasty resulting in bilateral renal infarcts and ischemic colitis

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