RESUMO
Needle biopsy of the spine yields a higher diagnostic accuracy when large bore instruments are used. The Harlow Wood vertebral biopsy needle, for instance, has an internal diameter of 3 mm. However, pulsatile bleeding may occur, especially when a tumoral lesion is biopsied. The authors noted 9 pulsatile bleedings in 238 needle biopsies (3.8%). A piece of Surgicel, brought in with the trephine guide and the obturator, was an efficient treatment. A second piece of Surgicel, soaked in 1:10.000 adrenaline, was sometimes necessary.
Assuntos
Biópsia por Agulha/efeitos adversos , Perda Sanguínea Cirúrgica/prevenção & controle , Celulose Oxidada/uso terapêutico , Coluna Vertebral/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha/instrumentação , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Agulhas , Fluxo Pulsátil , Estudos RetrospectivosRESUMO
The aim of this prospective study was to evaluate the efficacy of an injectable hydroxyapatite cement in combination with long posterior transpedicular instrumentation, without fusion, for the treatment of unstable thoracolumbar burst fractures. Ten patients with this type of fracture were treated in the period 1999-2000 with bisegmental posterior transpedicular stabilisation above and below the fracture site, indirect reduction of the fracture, and transpedicular injection of hydroxyapatite cement into the fractured vertebral body. Postoperatively the mean Cobb kyphotic deformity angle (CKDA) and vertebral compression index (VCI) were statistically improved (p < 0.001). Both variables deteriorated slightly between surgery and follow-up after +/- 39 months; this was statistically not significant for the CKDA (p > 0.05), but significant for the VCI (p < 0.001). These data suggest that hydroxyapatite cement can be a reliable way to reinforce the fractured vertebral body in the thoracolumbar region.
