Vertebroplasty

Moreland, Douglas B.; Landi, Michael K.; Grand, Walter

doi:10.1016/s1529-9430(01)00013-4

Cited by 97 publications

(12 citation statements)

References 13 publications

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“…This high bone density and thick bone trabecula make the needle placement and the injection procedure more challenging in sheep (personal surgical experience). To place the needle for percutaneous VP in the osteoporotic, brittle human bone, it only has to be tapped with a mallet to engage the cortical bone and afterwards can be pushed forward with manual pressure into the right position [25]. In contrast, in sheep, a hole had to be drilled first to be able to push the needle forward into the trabecular bone with the aid of a mallet.…”

Section: Discussionmentioning

confidence: 99%

“…Although it may not completely mimic vertebroplasty in osteoporotic human bone, it may be considered close enough to test substances in sheep for later use in human bone. During vertebroblasty in humans, leakage of bone cement is also reported as the most common complication [25,27]. Therefore, this animal model could provide important information about the material properties if leakage occurs during the injection procedure.…”

Section: Discussionmentioning

confidence: 99%

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Bone augmentation for cancellous bone-development of a new animal model

Klein

Zamparo

Kronen

et al. 2013

BMC Musculoskelet Disord

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BackgroundReproducible and suitable animal models are required for in vivo experiments to investigate new biodegradable and osteoinductive biomaterials for augmentation of bones at risk for osteoporotic fractures. Sheep have especially been used as a model for the human spine due to their size and similar bone metabolism. However, although sheep and human vertebral bodies have similar biomechanical characteristics, the shape of the vertebral bodies, the size of the transverse processes, and the different orientation of the facet joints of sheep are quite different from those of humans making the surgical approach complicated and unpredictable. Therefore, an adequate and safe animal model for bone augmentation was developed using a standardized femoral and tibia augmentation site in sheep.MethodsThe cancellous bone of the distal femur and proximal tibia were chosen as injection sites with the surgical approach via the medial aspects of the femoral condyle and proximal tibia metaphysis (n = 4 injection sites). For reproducible drilling and injection in a given direction and length, a custom-made c-shaped aiming device was designed. Exact positioning of the aiming device and needle positioning within the intertrabecular space of the intact bone could be validated in a predictable and standardized fashion using fluoroscopy. After sacrifice, bone cylinders (∅ 32 mm) were harvested throughout the tibia and femur by means of a diamond-coated core drill, which was especially developed to harvest the injected bone area exactly. Thereafter, the extracted bone cylinders were processed as non-decalcified specimens for μCT analysis, histomorphometry, histology, and fluorescence evaluation.ResultsThe aiming device could be easily placed in 63 sheep and assured a reproducible, standardized injection area. In four sheep, cardiovascular complications occurred during surgery and pulmonary embolism was detected by computed tomography post surgery in all of these animals. The harvesting and evaluative methods assured a standardized analysis of all samples.ConclusionsThis experimental animal model provides an excellent basis for testing new biomaterials for their suitability as bone augmentation materials. Concomitantly, similar cardiovascular changes occur during vertebroplasties as in humans, thus making it a suitable animal model for studies related to vertebroplasty.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bone augmentation for cancellous bone-development of a new animal model

Klein

Zamparo

Kronen

et al. 2013

BMC Musculoskelet Disord

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“…One of the main contraindications to vertebral augmentation is posterior wall involvement with bone fragments, particularly at levels above L1, because of the risk of vertebral channel cement backward leakage with potential spine cord impingement and the risk of pseudoarthrosis with pain relapse [26]. …”

Section: Discussionmentioning

confidence: 99%

Traumatic Burst Fracture with Spinal Channel Involvement Augmentation with Bioactive Strontium-Hydroxyapatite Cement

Masala

Calabria

Nano

et al. 2013

Case Reports in Orthopedics

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In November 2011 a 75-year-old man was admitted to our emergency department with a low back pain caused by a traumatic L1 vertebral collapse with backward projection of posterior wall superior third. The indication for neurosurgical instrumentation was placed, although he refused the treatment. Hence he was treated conservatively without a significant improvement up to January 2012 when, still refusing surgery, he accepted to undergo percutaneous vertebroplasty with a novel bioactive injectable strontium-hydroxyapatite cement. Vertebroplasty was performed without complications. A CT scan, performed the day after the procedure, ruled out extravertebral cement leakage. Pain improvement was significant (preprocedure VAS 10, one-week VAS 4) with a gradual decrease up to three months when it stabilized at 2. CT examination after 1 year showed a good cement osseointegration with osteophytic spurs bridging the superior endplate of the level involved to the inferior one of the level above. The new bone ingrowing property of the strontium-hydroxyapatite containing cement permits to extend the treatment indication also to unstable collapses in which the risk of pseudoarthrosis is very high. In this reported case we evaluated the potential role of percutaneous vertebroplasty in traumatic burst fracture with spinal channel involvement.

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“…Even though Moreland et al8 thought that the addition of antibiotic powder (Tobramycin; Abbott, Chicago, IL, USA) to PMMA during preparation had not demonstrated a benefit. Of the reports that were reviewed, only one infection was reported in 682 cases, and this was in immune-compromised patients who developed spondylodiscitis.…”

Section: Discussionmentioning

confidence: 99%

Pyogenic Spondylitis after Vertebroplasty - A Report of Two Cases -

Lee

Kim

2007

Asian Spine J

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Vertebroplasty is now extensively used worldwide for thoracic and lumbar osteoporotic compression fractures. Although percutaneous vertebroplasty is considered a minimally invasive procedure, it may result in several complications. In this report, we present two patients where pyogenic spondylitis developed after vertebroplasty surgery was required. The serious nature of these infections, surgical management and complication avoidance are discussed.

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Vertebroplasty

Cited by 97 publications

References 13 publications

Bone augmentation for cancellous bone-development of a new animal model

Bone augmentation for cancellous bone-development of a new animal model

Traumatic Burst Fracture with Spinal Channel Involvement Augmentation with Bioactive Strontium-Hydroxyapatite Cement

Pyogenic Spondylitis after Vertebroplasty - A Report of Two Cases -

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