Percutaneous Vertebroplasty: A New Serial Injection Technique to Minimize Cement Leak

STUDY DESIGN: This is a prospective cohort study. PURPOSE: This study discusses a new technique for injecting cement in the affected vertebrae. OVERVIEW OF LITERATURE: Since introduction of vertebroplasty to clinical practice, the cement leak is considered the most frequent and hazardous complication. In literature, the cement extravasation occurred in 26%-97% of the cases. METHODS: A hundred and twenty-three patients underwent vertebroplasty using the serial injection technique. The package of the cement powder and the solvent was divided into five equal parts. Each part of the powder and the solvent was mixed as a single dose and injected to the affected vertebra. The duration between subsequent injections was 10 minutes. Each injection consisted of 1-1.5 mL of cement. RESULTS: This new technique gives the surgeon enough time to make multiple separate injections using the same package. The time interval between injections hardens the cement just enough so that it does not get displaced by the next cement injection. This technique gives time to the preceding injected cement to seal off the cracks and cavities in the vertebra, and subsequently leads to a significant decrease in cement leak (p<0.001), as compared to literature. CONCLUSIONS: This study demonstrates a previously unreported technique for vertebroplasty that adds more safety to the procedure by significantly decreasing cement leak. It also makes the surgeon more relaxed due to time intervals, giving him more self-confidence whilst performing the procedure.

Percutaneous Vertebral Augmentation for the Treatment of Osteoporotic Spinal Fractures

STUDY DESIGN: Review of the literature. OBJECTIVES: To present updated information on percutaneous vertebral augmentation (PVA) for osteoporotic spinal fractures (OSFs). SUMMARY OF LITERATURE REVIEW: Vertebroplasty and kyphoplasty have been used to treat osteoporotic spinal fractures for many years. A recent meta-analysis provides strong evidence in favor of cement augmentation in the treatment of symptomatic vertebral compression fractures. MATERIALS AND METHODS: Review of the relevant literature. RESULTS: A meta-analysis showed greater pain relief, functional recovery, and improvement in quality of life with cement augmentation compared with control subjects. CONCLUSIONS: Percutaneous vertebral augmentation of osteoporotic spinal fractures results in shorter hospital stays, reduced incidence of complications, and more rapid return of functional independence.

The Epidemiology and Importance of Osteoporotic Spinal Compression Fracture in South Korea

STUDY DESIGN: Review of the literature on the epidemiology and importance of osteoporotic spinal fractures. OBJECTIVES: To determine the epidemiology and importance of osteoporotic spinal fractures. SUMMARY OF LITERATURE REVIEW: Osteoporotic spinal fractures have been increasing in recent years. MATERIALS AND METHODS: Review of the literature. RESULTS: Osteoporotic spinal fractures can lead to a reduced quality of life and reduced life expectancy with increasing morbidity. They can also be a major cause of additional spinal fractures or secondary fractures. CONCLUSIONS: In an aging society, osteoporotic spinal fractures are considered a social problem. Preventive care should be emphasized.