Percutaneous Cement Injection into a Created Cavity for the Treatment of Vertebral Body Fracture

Vallejo, Ricardo; Benyamin, Ramsin; Floyd, Bonnie; Casto, Joseph M.; Joseph, Ninos J.; Mekhail, Nagi

doi:10.1097/01.ajp.0000169675.41815.49

Cited by 15 publications

(4 citation statements)

References 35 publications

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“…Now that the Kyphon device is off patent, there are legions of copycat devices available from most manufacturers. A modified procedure employs reusable hingedtip curet to manually create a cavity in fractured vertebral bodies under fluoroscopy guidance, allowing low resistance injection of more viscous cement [82] . We have often used a similar curet to create space for the balloon when the hardness of the vertebral body prevented the balloon from creating a cavity of the appropriate size.…”

Section: Future Developmentsmentioning

confidence: 99%

Comparative review of vertebroplasty and kyphoplasty

Santiago¹,

Chinchilla²,

Álvarez³

et al. 2014

WJR

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The aim of this review is to compare the effectiveness of percutaneous vertebroplasty and kyphoplasty to treat pain and improve functional outcome from vertebral fractures secondary to osteoporosis and tumor conditions. In 2009, two open randomized controlled trials published in the New England Journal of Medicine questioned the value of vertebroplasty in treating vertebral compression fractures. Nevertheless, the practice of physicians treating these conditions has barely changed. The objective of this review is to try to clarify the most important issues, based on our own experience and the reported evidence about both techniques, and to guide towards the most appropriate choice of treatment of vertebral fractures, although many questions still remain unanswered.

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Section: Future Developmentsmentioning

confidence: 99%

Comparative review of vertebroplasty and kyphoplasty

Santiago¹,

Chinchilla²,

Álvarez³

et al. 2014

WJR

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“…However, using the screw-syringe pressure application, which increases the pressure that is applied to the cement, may introduce additional risks of leakage due to the loss of tactile feedback of cement delivery and the higher injection pressure. To overcome the limitations of vertebroplasty associated with the excessive pressure required to inject suffi cient cement into a fractured body, can-nulae have been designed with larger proximal portion internal diameters [21] and a reusable hinged-tip curet to manually create a cavity was employed [22] . The modifi ed vertebroplasty technique described in the present study creates small cavities and micro-connections with the fracture gaps in the vertebral body using a curved probe.…”

Section: Discussionmentioning

confidence: 99%

Modified Vertebroplasty using a Curved Probe: Technique and Preliminary Results

Kwon¹

2008

Minim Invasive Neurosurg

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“…Therefore, leak rates should not be compared between studies without mentioning the method of leak detection. There have been various reports on techniques for leak rate reduction in vertebroplasty [23,24]. Using a Fogarty balloon inflation for hole creation, Schulte et al [24] reported epidural cement leaks in 9.1% and intradiscal leaks in 10.6%.…”

Section: Discussionmentioning

confidence: 99%

CT-guided vertebroplasty in osteoprotic vertebral fractures: incidence of secondary fractures and impact of intradiscal cement leakages during follow-up

et al. 2007

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The purpose of this study was to analyse the number and types of secondary fractures, and to investigate the impact of intradiscal cement leaks for adjacent vertebral fractures. Patients with osteoporotic vertebral fractures were treated with vertebroplasty. Results were documented and prospectively followed by means of computed tomography (CT) and magnetic resonance imaging. The frequency and the types of cement leakages were analysed from multiplanar CT images and secondary fractures were characterised as follows: (1) adjacent fracture in the immediate vicinity of an augmented vertebra; (2) sandwich fracture, fracture of an untreated vertebra between two vertebrae that had been previously augmented, and (3) distant fractures not in the vicinity of augmented vertebrae. A total of 385 osteoporotic vertebral fractures were treated in 191 patients (61 men, 130 women, age 70.7 +/- 9.7 years). The overall rate of cement leaks was 55.6%, including all leaks detectable by CT. Intradiscal leaks through the upper, the lower, and both endplates occurred in 18.2%, 6.8%, and 2.6%, respectively. In 39 patients (20.4%), a total of 72 secondary fractures occurred: 30 adjacent fractures in 23 patients (12.0%) with a time to fracture of 2 months [median; 1.0/4.0 months, first/third quartile (Q1/Q3)]; 11 secondary sandwich fractures in 11 patients (5.8%) after 1.5 months (median; 0.25/7.5 months, Q1/Q3); and 31 distant fractures in 20 patients (10.5%) after 5 months (median; 2.0/8.0 months, Q1/Q3). Ten of 30 adjacent fractures occurred in the presence of pre-existing intradiscal cement leaks and 20 where there was no leakage. Six of 11 sandwich fractures occurred in the presence of intradiscal leaks (five leaks in both adjacent disc spaces, one leak in the lower disc space) and five where there was no leakage. The rate of secondary adjacent and non-adjacent fractures is quite similar and there is no specific impact of intradiscal leakages on the occurrence of adjacent secondary fractures. Adjacent fractures occur sooner than distant secondary fractures. Sandwich fractures are associated with specific biomechanical conditions, with a 37.9% fracture rate in sandwich constellations.

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Percutaneous Cement Injection into a Created Cavity for the Treatment of Vertebral Body Fracture

Abstract: The Cavity Creation System is a safe, cost-effective treatment of VBF resulting in good/excellent pain relief and an improved quality of life.

Cited by 15 publications

References 35 publications

Comparative review of vertebroplasty and kyphoplasty

Comparative review of vertebroplasty and kyphoplasty

Modified Vertebroplasty using a Curved Probe: Technique and Preliminary Results

CT-guided vertebroplasty in osteoprotic vertebral fractures: incidence of secondary fractures and impact of intradiscal cement leakages during follow-up

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