Percutaneous Vertebroplasty and Bone Cement Leakage: Clinical Experience with a New High-Viscosity Bone Cement and Delivery System for Vertebral Augmentation in Benign and Malignant Compression Fractures
- University of Maryland, Radiology and Radiological Science (United States)
- Institute for Cancer Research and Treatment (IRCC), Radiology Unit (Italy)
- University 'Tor Vergata', Radiology Unit and Interventional Radiology Unit (Italy)
The aim of this study was to assess the feasibility of and venous leakage reduction in percutaneous vertebroplasty (PV) using a new high-viscosity bone cement (PMMA). PV has been used effectively for pain relief in osteoporotic and malignant vertebral fractures. Cement extrusion is a common problem and can lead to complications. Sixty patients (52 female; mean age, 72.2 {+-} 7.2) suffering from osteoporosis (46), malignancy (12), and angiomas (2), divided into two groups (A and B), underwent PV on 190 vertebrae (86 dorsal, 104 lumbar). In Group A, PV with high-viscosity PMMA (Confidence, Disc-O-Tech, Israel) was used. This PMMA was injected by a proprietary delivery system, a hydraulic saline-filled screw injector. In Group B, a standard low-viscosity PMMA was used. Postprocedural CT was carried out to detect PMMA leakages and complications. Fisher's exact test and Wilcoxon rank test were used to assess significant differences (p < 0.05) in leakages and to evaluate the clinical outcome. PV was feasible, achieving good clinical outcome (p < 0.0001) without major complications. In Group A, postprocedural CT showed an asymptomatic leak in the venous structures of 8 of 98 (8.2%) treated vertebrae; a discoidal leak occurred in 6 of 98 (6.1%). In Group B, a venous leak was seen in 38 of 92 (41.3%) and a discoidal leak in 12 of 92 (13.0%). Reduction of venous leak obtained by high-viscosity PMMA was highly significant (p < 0.0001), whereas this result was not significant (p = 0.14) related to the disc. The high-viscosity PMMA system is safe and effective for clinical use, allowing a significant reduction of extravasation rate and, thus, leakage-related complications.
- OSTI ID:
- 21450339
- Journal Information:
- Cardiovascular and Interventional Radiology, Vol. 31, Issue 5; Other Information: DOI: 10.1007/s00270-008-9324-6; Copyright (c) 2008 Springer Science+Business Media, LLC; ISSN 0174-1551
- Country of Publication:
- United States
- Language:
- English
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ANGIOMAS
CEMENTS
FRACTURES
INJECTION
LEAKS
OSTEOPOROSIS
PMMA
REDUCTION
VERTEBRAE
VISCOSITY
BODY
BUILDING MATERIALS
CARCINOMAS
CHEMICAL REACTIONS
DISEASES
ESTERS
FAILURES
INTAKE
MATERIALS
NEOPLASMS
ORGANIC COMPOUNDS
ORGANIC POLYMERS
ORGANS
POLYACRYLATES
POLYMERS
POLYVINYLS
SKELETAL DISEASES
SKELETON