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Title: 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

Abstract

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,more » 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.« less

Authors:
 [1];  [2];  [3];  [4]; ; ;  [3]
  1. Institute for Cancer Research and Treatment (IRCC), Interventional Radiology Unit (Italy)
  2. University of Maryland, Radiology and Radiological Science (United States)
  3. Institute for Cancer Research and Treatment (IRCC), Radiology Unit (Italy)
  4. University 'Tor Vergata', Radiology Unit and Interventional Radiology Unit (Italy)
Publication Date:
OSTI Identifier:
21450339
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 31; Journal Issue: 5; Other Information: DOI: 10.1007/s00270-008-9324-6; Copyright (c) 2008 Springer Science+Business Media, LLC; Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; 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

Citation Formats

Anselmetti, Giovanni Carlo, E-mail: giovanni.anselmetti@ircc.i, Zoarski, Gregg, Manca, Antonio, Masala, Salvatore, Eminefendic, Haris, Russo, Filippo, and Regge, Daniele. 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. United States: N. p., 2008. Web. doi:10.1007/S00270-008-9324-6.
Anselmetti, Giovanni Carlo, E-mail: giovanni.anselmetti@ircc.i, Zoarski, Gregg, Manca, Antonio, Masala, Salvatore, Eminefendic, Haris, Russo, Filippo, & Regge, Daniele. 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. United States. doi:10.1007/S00270-008-9324-6.
Anselmetti, Giovanni Carlo, E-mail: giovanni.anselmetti@ircc.i, Zoarski, Gregg, Manca, Antonio, Masala, Salvatore, Eminefendic, Haris, Russo, Filippo, and Regge, Daniele. Mon . "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". United States. doi:10.1007/S00270-008-9324-6.
@article{osti_21450339,
title = {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},
author = {Anselmetti, Giovanni Carlo, E-mail: giovanni.anselmetti@ircc.i and Zoarski, Gregg and Manca, Antonio and Masala, Salvatore and Eminefendic, Haris and Russo, Filippo and Regge, Daniele},
abstractNote = {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.},
doi = {10.1007/S00270-008-9324-6},
journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 5,
volume = 31,
place = {United States},
year = {2008},
month = {9}
}