Modified Vertebroplasty using a Curved Probe: Technique and Preliminary Results

Abstract

The described modification of vertebroplasty involving the creation of small cavities using a curved probe appears to control cement injection easily during the procedures and minimize cement leakage-related complications.

Complications of Percutaneous Vertebroplasty

“…Therefore, to achieve the adequate filling of the cement into the vertebral body, it is imperative to inject more viscous cement under lower injection pressure. 7 This study did not quantify the injection pressure precisely; therefore, further studies measuring the pressure required for injection should be undertaken to clarify these preliminary results.…”

“…6 These procedures provide new options for compression fractures to relieve pain and reduce or stabilize fractures, so spinal deformity and further neurological compromise can be reduced. 7 One of the greatest drawbacks of vertebroplasty is the leakage of cement into the venous system or epidural space, which introduce the risks of spinal cord and nerve root compression, and of pulmonary embolism. These complications are often caused by the high cement injection pressures that are sometimes required.…”

“…As the cement must be forced into the cancellous bone matrix to fill sufficiently and because of the low viscosity of the injectate, incidences of cement leakage range from 12% to 65%. 7 Moreover, fractured segment restoration becomes more possible owing to the vertebral height increase. It is essential to have adequate radiographic and fluoroscopic guidance during the procedure, and for full control of the injection, the cement should be injected at the proper stage of polymerization without significant resistance.…”

“…Since then, this minimally invasive procedure is designed to treat painful vertebral body and provide stability to vertebrae that have been structurally weakened by primary or secondary spinal tumors, osteoporosis, lytic lesions, compression fractures, hemangiomas, and other spine pathologies such as vertebral myeloma, lymphoma, aneurismal bone cyst, and Paget disease-induced fractures. [1][2][3][4][5][6][7][8][9][10] It is a radiologically guided therapeutic procedure involving percutaneous injection of bone cement into the vertebral body. 1 In the treatment of osteoporotic fractures, partial or complete relief of symptoms and restoration of mobility within 24 hours of the procedure has been reported in up to 90% of patients, with a related complication rate of 1.3%.…”

“…It is necessary to reduce symptoms and mobilize the patient as quickly as possible in the acute management phase. [7][8][9][10] However, vertebroplasty is not without its attendant risks, and most of the complications encountered are owing to cement leakage, which usually occurs when excessive pressure is applied to inject sufficient cement into a vertebral body. 7 In this paper, the researchers provide procedure results and functional outcomes in a series of 28 patients with 30 symptomatic vertebral compression fractures treated by means of percutaneous polymethyl methacrylate vertebroplasty.…”