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Title: CIRSE Guidelines on Percutaneous Vertebral Augmentation

Abstract

Vertebral compression fracture (VCF) is an important cause of severe debilitating back pain, adversely affecting quality of life, physical function, psychosocial performance, mental health and survival. Different vertebral augmentation procedures (VAPs) are used in order to consolidate the VCFs, relief pain,and whenever posible achieve vertebral body height restoration. In the present review we give the indications, contraindications, safety profile and outcomes of the existing percutaneous VAPs.

Authors:
; ; ; ; ; ;  [1]
  1. Strasbourg University Hospital, Interventional Radiology Department (France)
Publication Date:
OSTI Identifier:
22645293
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 3; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; AUGMENTATION; BIOLOGICAL RECOVERY; HEIGHT; PAIN; PERFORMANCE; RECOMMENDATIONS; REVIEWS; SAFETY; VERTEBRAE

Citation Formats

Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com, Too, Chow Wei, E-mail: spyder55@gmail.com, Koch, Guillaume, E-mail: guillaume.koch@gmail.com, Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr, Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it, Garnon, Julien, E-mail: juliengarnon@gmail.com, and Gangi, Afshin, E-mail: gangi@unistra.fr. CIRSE Guidelines on Percutaneous Vertebral Augmentation. United States: N. p., 2017. Web. doi:10.1007/S00270-017-1574-8.
Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com, Too, Chow Wei, E-mail: spyder55@gmail.com, Koch, Guillaume, E-mail: guillaume.koch@gmail.com, Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr, Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it, Garnon, Julien, E-mail: juliengarnon@gmail.com, & Gangi, Afshin, E-mail: gangi@unistra.fr. CIRSE Guidelines on Percutaneous Vertebral Augmentation. United States. doi:10.1007/S00270-017-1574-8.
Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com, Too, Chow Wei, E-mail: spyder55@gmail.com, Koch, Guillaume, E-mail: guillaume.koch@gmail.com, Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr, Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it, Garnon, Julien, E-mail: juliengarnon@gmail.com, and Gangi, Afshin, E-mail: gangi@unistra.fr. Wed . "CIRSE Guidelines on Percutaneous Vertebral Augmentation". United States. doi:10.1007/S00270-017-1574-8.
@article{osti_22645293,
title = {CIRSE Guidelines on Percutaneous Vertebral Augmentation},
author = {Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com and Too, Chow Wei, E-mail: spyder55@gmail.com and Koch, Guillaume, E-mail: guillaume.koch@gmail.com and Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr and Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it and Garnon, Julien, E-mail: juliengarnon@gmail.com and Gangi, Afshin, E-mail: gangi@unistra.fr},
abstractNote = {Vertebral compression fracture (VCF) is an important cause of severe debilitating back pain, adversely affecting quality of life, physical function, psychosocial performance, mental health and survival. Different vertebral augmentation procedures (VAPs) are used in order to consolidate the VCFs, relief pain,and whenever posible achieve vertebral body height restoration. In the present review we give the indications, contraindications, safety profile and outcomes of the existing percutaneous VAPs.},
doi = {10.1007/S00270-017-1574-8},
journal = {Cardiovascular and Interventional Radiology},
number = 3,
volume = 40,
place = {United States},
year = {Wed Mar 15 00:00:00 EDT 2017},
month = {Wed Mar 15 00:00:00 EDT 2017}
}
  • No abstract prepared.
  • 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 wasmore » 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.« less
  • The purpose of this study was to investigate geometrical stability and preservation of height gain of vertebral bodies after percutaneous vertebroplasty during 2 years' follow-up and to elucidate the geometric remodeling process of the vertebral bidisk unit (VDU) of the affected segment. Patients with osteoporotic vertebral compression fractures with pain resistant to analgetic drugs were treated with polymethylmethacrylate vertebroplasty. Mean {+-} standard error cement volume was 5.1 {+-} 2.0 ml. Vertebral geometry was documented by sagittal and coronal reformations from multidetector computed tomography data sets: anterior, posterior, and lateral vertebral heights, end plate angles, and compression index (CI = anterior/posteriormore » height). Additionally, the VDU (vertebral bodies plus both adjacent disk spaces) was calculated from the multidetector computed tomography data sets: anterior, posterior, and both lateral aspects. Patients were assigned to two groups: moderate compression with CI of >0.75 (group 1) and severe compression with CI of <0.75 (group 2). A total of 83 vertebral bodies of 30 patients (7 men, 23 women, age 70.7 {+-} 9.7 years, range 40-82 years) were treated with vertebroplasty and prospectively followed for 24 months. In the moderate compression group (group 1), the vertebral heights were stabilized over time at the preinterventional levels. Compared with group 1, group 2 showed a greater anterior height gain (+2.8 {+-} 2.2 mm vs. +0.8 {+-} 2.0 mm, P < 0.001), better reduction of end plate angle (-4.9 {+-} 4.8{sup o} vs. -1.0 {+-} 2.7{sup o}, P < 0.01), and improved CI (+0.12 {+-} 0.13 vs. +0.02 {+-} 0.07, P < 0.01) and demonstrated preserved anterior height gain at 2 years (+1.2 {+-} 3.2 mm, P < 0.01) as well as improved end plate angles (-5.2 {+-} 5.0{sup o}, P < 0.01) and compression indices (+0.11 {+-} 0.15, P < 0.01). Thus, posterior height loss of vertebrae and adjacent intervertebral disk spaces contributed to a remodeling of the VDU, resulting in some compensation of the kyphotic malposition of the affected vertebral segment. Vertebroplasty improved vertebral geometry during midterm follow-up. In severe vertebral compression, significant height gain and improvement of end plate angles were achieved. The remodeling of the VDUs contributes to reduction of kyphosis and an overall improvement of the statics of the spine.« less
  • No abstract prepared.
  • No abstract prepared.