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DOI: 10.1055/s-2008-1073134
© Georg Thieme Verlag KG Stuttgart · New York
Modified Vertebroplasty using a Curved Probe: Technique and Preliminary Results
Publication History
Publication Date:
02 June 2008 (online)

Abstract
Objective: One of the main limitations of vertebroplasty is the excessive pressure required for injection of sufficient cement into a vertebral body. Kyphoplasty can be used to reduce injection pressure by making a void with a balloon tamp. The author presents a technique of making small voids to reduce cement delivery pressure during vertebroplasty that involves a simple modification of the conventional technique.
Methods: The author performed this modified vertebroplasty in 48 patients with an acute vertebral compression fracture. Small voids and micro-connections with the fracture gaps in the vertebral body were created using a curved probe placed into the vertebral body through a working cannula. Visual analogue scale (VAS) scores were measured preoperatively and at 1 week and 3 months postoperatively. Forty patients with osteoporotic VCFs were followed for a mean period of 6months.
Results: All 48 patients showed a significant reduction in visual analogue pain scores at 1 week and 3 months postoperatively versus preoperative levels (p<0.001, respectively). No device-related complications or major cement leakages that caused postoperative neurological deficits or pulmonary complications were noted.
Conclusion: The described modification of vertebroplasty involving the creation of small cavities using a curved probe appears to control cement injection easily during the procedures and minimize cement leakage-related complications.
Key words
vertebroplasty - curved probe - voids - micro-connection
References
- 1 Galibert P, Deramond H, Rosat P, Le Gars D. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie. 1987; 33 166-168
- 2 Yeom JS, Kim WJ, Choy WS. et al . Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures. J Bone Joint Surg [Br]. 2003; 85 83-89
- 3 Al-Assir I, Perez-Higueras A, Florensa J, Munoz A, Cuesta E. Percutaneous vertebroplasty: a special syringe for cement injection. AJNR Am J Neuroradiol. 2000; 21 159-161
- 4 Phillips FM. Minimally invasive treatments of osteoporotic vertebral compression fractures. Spine. 2003; 28 S45-S53
- 5 Phillips FM, Ho E, Campbell-Hupp M. et al . Early radiographic and clinical results of balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures. Spine. 2003; 28 2260-2265 , ; discussion 2265-2267
- 6 Lieberman IH, Dudeney S, Reinhardt MK, Bell G. Initial outcome and efficacy of „kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine. 2001; 26 1631-1638
- 7 Lee BJ, Lee SR, Yoo TY. Paraplegia as a complication of percutaneous vertebroplasty with polymethylmethacrylate: a case report. Spine. 2002; 27 E419-E422
- 8 Ratliff J, Nguyen T, Heiss J. Root and spinal cord compression from methylmethacrylate vertebroplasty. Spine. 2001; 26 E300-E302
- 9 Jang JS, Lee SH, Jung SK. Pulmonary embolism of polymethyl methacrylate after percutaneous vertebroplasty: a report of three cases. Spine. 2002; 27 E416-E418
- 10 Chen HL, Wong CS, Ho ST. et al . A lethal pulmonary embolism during percutaneous vertebroplasty. Anesth Analg. 2002; 95 1060-1062 , (table of contents)
- 11 Cortet B, Cotten A, Boutry N. et al . Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study. J Rheumatol. 1999; 26 2222-2228
- 12 Tsou IY, Goh PY, Peh WC, Goh LA, Chee TS. Percutaneous vertebroplasty in the management of osteoporotic vertebral compression fractures: initial experience. Ann Acad Med Singapore. 2002; 31 15-20
- 13 Gaughen Jr JR, Jensen ME, Schweickert PA. et al . Relevance of antecedent venography in percutaneous vertebroplasty for the treatment of osteoporotic compression fractures. AJNR Am J Neuroradiol. 2002; 23 594-600
- 14 Belkoff SM, Mathis JM, Fenton DC. et al . An ex vivo biomechanical evaluation of an inflatable bone tamp used in the treatment of compression fracture. Spine. 2001; 26 151-156
- 15 Garfin SR, Yuan HA, Reiley MA. New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine. 2001; 26 1511-1515
- 16 Ledlie JT, Renfro M. Balloon kyphoplasty: one-year outcomes in vertebral body height restoration, chronic pain, and activity levels. J Neurosurg. 2003; 98 36-42
- 17 Phillips FM, Todd Wetzel F, Lieberman I, Campbell-Hupp M. An in vivo comparison of the potential for extravertebral cement leak after vertebroplasty and kyphoplasty. Spine. 2002; 27 2173-2178 , ; discussion 2178-2179
- 18 Nussbaum DA, Gailloud P, Murphy K. A review of complications associated with vertebroplasty and kyphoplasty as reported to the Food and Drug Administration medical device related web site. J Vasc Interv Radiol. 2004; 15 1185-1192
- 19 Theodorou DJ, Theodorou SJ, Duncan TD, Garfin SR, Wong WH. Percutaneous balloon kyphoplasty for the correction of spinal deformity in painful vertebral body compression fractures. Clinical imaging. 2002; 26 1-5
- 20 Ortiz AO, Zoarski GH, Beckerman M. Kyphoplasty. Techniques in vascular and interventional radiology. 2002; 5 239-249
- 21 Baroud G, Steffen T. A new cannula to ease cement injection during vertebroplasty. Eur Spine J. 2005; 14 474-479
- 22 Vallejo R, Benyamin R, Floyd B. et al . Percutaneous cement injection into a created cavity for the treatment of vertebral body fracture: preliminary results of a new vertebroplasty technique. Clin J Pain. 2006; 22 182-189
- 23 Lee ST, Chen JF. A syringe compressor for vertebroplasty: technical note. Surg Neurol. 2004; 61 580-584
Correspondence
Y.J. KwonMD, PhD
Department of Neurosurgery
Kangbuk Samsung Hospital
Sungkyunkwan University School of Medicine
108 Pyung-Dong
Jongno-Ku
Seoul 110-746
South Korea
Phone: +82/2/2001 24 50
Fax: +82/2/2001 21 57
Email: neuriac@skku.edu