Reduction of cement leakage by sequential PMMA application in a vertebroplasty model

Hoppe, Sven; Wangler, Sebastian; Aghayev, Emin; Gantenbein, Benjamin; Böger, Andreas; Benneker, Lorin Michael

doi:10.1007/s00586-015-3920-3

Cited by 26 publications

(26 citation statements)

References 21 publications

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“…Conversely, increasing the amount of cement injection may increase the incidence of cement leakage [11][12][13]. Clinical studies have shown that 70% of complications of vertebral body forming are associated with the cement leakage [14][15][16][17]. To overcome the shortcomings of PVP technology in the area of sufficient and symmetrical cement distribution, the flexible bone cement injector was designed to deliver bone cement at three zones in the vertebral body.…”

Section: Feasibility Safety and Clinical Efficacy Of Pvp With Flexibmentioning

confidence: 99%

Comparison of a flexible versus rigid bone cement injection system in unilateral percutaneous vertebroplasty

Cui

Zhou

et al. 2020

Eur J Med Res

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Background: Percutaneous vertebroplasty (PVP) has been demonstrated to be effective in the treatment of acute osteoporotic vertebral fracture (AOVF). However, bilateral puncture takes more time to accept more X-ray irradiation; some scholars apply unilateral puncture PVP, but the cement cannot be symmetrically distributed in the vertebral body, so we use a flexible cement injector that undergoes PVP through the unilateral pedicle puncture. This research aims to compare the clinical results of PVP for AOVF with unilateral pedicle puncture using a straight bone cement injector and a bendable cement injector, determine the value of a bendable cement injector. Methods: We undertook a retrospective analysis of patients with thoracic and lumbar compression fracture treated with unilateral pedicle puncture percutaneous vertebroplasty from our institution from June 2013 to July 2015. Operation time, radiation exposure, bone cement injection amount, and the incidence of bone cement leakage were recorded on presentation, the cement leakage was measured by X-ray and computed tomography scan. The patients were followed up postoperatively and were assessed mainly with regard to clinical and radiological outcomes. Results: There was no significant difference in the operation time, radiation exposure time and incidence of bone cement leakage between the two groups. There was significant difference in the amount of bone cement injection and the difference between the two groups. There were no significant differences in VAS and the relative height of the vertebral body and local Cobb angle and QUALEFFO between the two groups at 1 week after PVP, significant difference was observed only 12 months after operation. Conclusions: Application of flexible cement injector is safe and feasible, compared with the application of straight bone cement injector, without prolonging the operative time, radiation exposure time and the incidence of bone cement leakage; it has the advantages of good long-term effect and low incidence of vertebral fracture recurrence.

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Section: Feasibility Safety and Clinical Efficacy Of Pvp With Flexibmentioning

confidence: 99%

Comparison of a flexible versus rigid bone cement injection system in unilateral percutaneous vertebroplasty

Cui

Zhou

et al. 2020

Eur J Med Res

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“…In a standard model, leakage can be significantly reduced by the sequential application of small cement amounts. Possible leakage paths are blocked before reapplication of the low-viscous cement [35]. Moreover, the development of high-viscous PMMA cements have reduced the rate of cement leakages significantly, resulting in the disadvantage of the need for high-pressure injection devices that are more expensive and lack tactile feedback.…”

Section: Complicationsmentioning

confidence: 99%

Percutaneous cement augmentation techniques for osteoporotic spinal fractures

Benneker

Hoppe

2013

Eur J Trauma Emerg Surg

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Minimally invasive vertebral augmentation-based techniques have been used for the treatment of spinal fractures (osteoporotic and malignant) for approximately 25 years. In this review, we try to give an overview of the current spectrum of percutaneous augmentation techniques, safety aspects and indications. Crucial factors for success are careful patient selection, proper technique and choice of the ideal cement augmentation option. Most compression fractures present a favourable natural course, with reduction of pain and regainment of mobility after a few days to several weeks, whereas other patients experience a progressive collapse and persisting pain. In this situation, percutaneous cement augmentation is an effective treatment option with regards to pain and disability reduction, improvement of quality of life and ambulatory and pulmonary function.

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“…The cement viscosity issue is also a crucial parameter that is associated with the risk of cement leakage [23,24]. Injecting PMMA at a low viscosity leads to a scattered, fingerlike, uncontrolled cement distribution pattern and, as a consequence, an increased chance of cement leakage.…”

Section: Introductionmentioning

confidence: 99%