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

Percutaneous vertebroplasty (PVP) is a minimally invasive treatment that has been widely used for the treatment of osteoporotic vertebral compression fractures and vertebral tumors. However, the maximum number of vertebral segments treated in a single PVP remains controversial. Furthermore, PVP may cause complications, including cement leakage, pulmonary embolism, bone cement toxicity, and spinal nerve-puncture injury. We report the rare case of a patient who underwent multilevel PVP for vertebral metastases, with no bone cement leakage or spinal cord injury, but who developed temporary paraparesis.

Download Full-text

Decompressed percutaneous vertebroplasty: A secured bone cement delivery procedure for vertebral augmentation in osteoporotic compression fractures

Injury ◽

10.1016/j.injury.2012.10.017 ◽

2013 ◽

Vol 44 (6) ◽

pp. 813-818 ◽

Cited By ~ 6

Author(s):

William Chu ◽

Yu-Chuan Tsuei ◽

Pei-Hung Liao ◽

Jiun-Hung Lin ◽

Wen-Hsiang Chou ◽

...

Keyword(s):

Bone Cement ◽

Percutaneous Vertebroplasty ◽

Vertebral Augmentation ◽

Compression Fractures ◽

Osteoporotic Compression Fractures

Download Full-text

Unilateral percutaneous vertebroplasty for osteoporotic lumbar compression fractures: a comparative study between transverse process root-pedicle approach and conventional transpedicular approach

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02219-6 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Wenwu Zhang ◽

Shenpeng Liu ◽

Xianhua Liu ◽

Xiang Li ◽

Le Wang ◽

...

Keyword(s):

Bone Cement ◽

Percutaneous Vertebroplasty ◽

Operation Time ◽

Transverse Process ◽

Cement Leakage ◽

Clinical Results ◽

Clinical Effects ◽

Compression Fractures ◽

Transpedicular Approach ◽

Cement Distribution

Abstract Purpose Percutaneous vertebroplasty (PVP) is a routine operation for the treatment of osteoporotic lumbar compression fractures (OLCFs). As is well known, unilateral puncture is a common method. However, with the conventional transpedicular approach (CTPA), the cement may be asymmetrically dispersed, so some surgeons use the transverse process root-pedicle approach (TPRPA). The objective of this study was to compare the clinical results and bone cement distribution of PVP for OLCF with unilateral TPRPA and CTPA to identify the advantages and disadvantages of the two surgical options. Patients and methods From January 2016 to June 2019, seventy-two elderly patients who underwent unilateral PVP for single-level OLCF were retrospectively reviewed. Operation time, injection amount and type of bone cement distribution, and bone cement leakage and surgical complications were recorded. The visual analog scale (VAS) scores and Oswestry disability index (ODI) scores were used to evaluate the clinical results. All patients were followed up for more than 12 months, and the assessment was based primarily on clinical and radiological outcomes. Results There were significant differences in the surgical time and the volume and the type of bone cement distribution and the lost of operative vertebra height between the two groups. However, there was no significant difference in bone cement leakage. Moreover, there were no significant differences in VAS and ODI between the two groups at 2 days and 12 months after the operation. Conclusions Unilateral TPRPA and CTPA are practical and feasible methods in PVP for the treatment of OLCF, and they have similar clinical effects. However, TPRPA has the advantages of a better distribution of bone cement and a shorter operation time and a better maintenance effect of injured vertebra height, without increasing the rate of bone cement leakage.

Download Full-text

High-viscosity bone cement for vertebral compression fractures: a prospective study on intravertebral diffusion of bone cement

10.21203/rs.2.23656/v1 ◽

2020 ◽

Author(s):

meiyong wang ◽

qunhua jin

Keyword(s):

Diffusion Coefficient ◽

Bone Cement ◽

Statistical Significance ◽

Cement Leakage ◽

High Viscosity ◽

Vertebral Compression Fractures ◽

Injection Time ◽

Time Duration ◽

Compression Fractures ◽

Group B

Abstract Objective Bone cement leakage causes severe complication following percutaneous vertebroplasty. This study probed the diffusion and leakage status of bone cement injected within diverged time duration, so as to find the optimal injection time for bone cement. Methods A total of 70 patients with osteoporotic vertebral compression fractures with a symptom of low back pain, who underwent treatment at hospital were enrolled in this study. Patients were randomized into three groups: <180 s, 180-300, and >300 s of injection time duration from the beginning to the completion of the injection. The scenarios of vertebral bone cement leakage and diffusion were inspected using postoperative CT. Results The diffusion coefficient was higher in group A than in group B whereas it was higher in group B than in group C, but without statistical significance among the three groups. The leakage rate was without statistical significance among the three groups. The injection time of bone cement was negatively correlated with the diffusion coefficient, at the correlation coefficient of -0.253. Conclusions The diffusion coefficient of high-viscosity bone cement is likely negatively correlated with the injection time, and the leakage rate of high-viscosity bone cement probably does not reduce with the prolongation of injection time.

Download Full-text

High-viscosity bone cement for vertebral compression fractures: a prospective study on intravertebral diffusion of bone cement

10.21203/rs.3.rs-22514/v1 ◽

2020 ◽

Author(s):

meiyong wang ◽

qunhua jin

Keyword(s):

Diffusion Coefficient ◽

Bone Cement ◽

Statistical Significance ◽

Cement Leakage ◽

High Viscosity ◽

Vertebral Compression Fractures ◽

Injection Time ◽

Time Duration ◽

Compression Fractures ◽

Group B

Abstract Objective: Bone cement leakage causes severe complication following percutaneous vertebroplasty. This study probed the diffusion and leakage status of bone cement injected within diverged time duration, so as to find the optimal injection time for bone cement. Methods: A total of 70 patients with osteoporotic vertebral compression fractures with a symptom of low back pain, who underwent treatment at hospital were enrolled in this study. Patients were randomized into three groups: <180 s, 180-300, and >300 s of injection time duration from the beginning to the completion of the injection. The scenarios of vertebral bone cement leakage and diffusion were inspected using postoperative CT.Results: The diffusion coefficient was higher in group A than in group B whereas it was higher in group B than in group C, but without statistical significance among the three groups. The leakage rate was without statistical significance among the three groups. The injection time of bone cement was negatively correlated with the diffusion coefficient, at the correlation coefficient of -0.253. Conclusions: The diffusion coefficient of high-viscosity bone cement is likely negatively correlated with the injection time, and the leakage rate of high-viscosity bone cement probably does not reduce with the prolongation of injection time.

Download Full-text

Role of percutaneous vertebroplasty with high-viscosity cement in the treatment of severe osteoporotic vertebral compression fractures

Scientific Reports ◽

10.1038/s41598-021-84314-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kunpeng Li ◽

Changbin Ji ◽

Dawei Luo ◽

Wen Zhang ◽

Hongyong Feng ◽

...

Keyword(s):

Cobb Angle ◽

Operative Time ◽

Percutaneous Vertebroplasty ◽

Cement Leakage ◽

High Viscosity ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Vertebral Height ◽

Compression Fractures ◽

One Year

AbstractSevere osteoporotic vertebral compression fractures (OVCFs) were considered as relative or even absolute contraindication for vertebroplasty and kyphoplasty and these relevant reports are very limited. This study aimed to evaluate and compare the efficacy of vertebroplasty with high-viscosity cement and conventional kyphoplasty in managing severe OVCFs. 37 patients of severe OVCFs experiencing vertebroplasty or kyphoplasty were reviewed and divided into two groups, according to the procedural technique, 18 in high-viscosity cement percutaneous vertebroplasty (hPVP) group and 19 in conventional percutaneous kyphoplasty (cPKP) group. The operative time, and injected bone cement volume were recorded. Anterior vertebral height (AVH), Cobb angle and cement leakage were also evaluated in the radiograph. The rate of cement leakage was lower in hPVP group, compared with cPKP group (16.7% vs 47.4%, P = 0.046). The patients in cPKP group achieved more improvement in AVH and Cobb angle than those in hPVP group postoperatively (37.2 ± 7.9% vs 43.0 ± 8.9% for AVH, P = 0.044; 15.5 ± 4.7 vs 12.7 ± 3.3, for Cobb angle, P = 0.042). At one year postoperatively, there was difference observed in AVH between two groups (34.1 ± 7.4 vs 40.5 ± 8.7 for hPVP and cPKP groups, P = 0.021), but no difference was found in Cobb angle (16.6 ± 5.0 vs 13.8 ± 3.8, P = 0.068). Similar cement volume was injected in two groups (2.9 ± 0.5 ml vs 2.8 ± 0.6 ml, P = 0.511). However, the operative time was 37.8 ± 6.8 min in the hPVP group, which was shorter than that in the cPKP group (43.8 ± 8.2 min, P = 0.021). In conclusion, conventional PKP achieved better in restoring anterior vertebral height and improving kyphotic angle, but PVP with high-viscosity cement had lower rate of cement leakage and shorter operative time with similar volume of injected cement.

Download Full-text

Comparison of early results of Vesselplasty and percutaneous vertebroplasty in the treatment of elderly patients with osteoporotic vertebral compression fracture

10.21203/rs.3.rs-17452/v1 ◽

2020 ◽

Author(s):

jun mei ◽

Dou Wu ◽

Xu Xiao Song ◽

Qiang Liu

Keyword(s):

Bone Cement ◽

Operative Time ◽

Percutaneous Vertebroplasty ◽

Cement Leakage ◽

Postoperative Recovery ◽

Leakage Rate ◽

Vertebral Compression Fractures ◽

Vertebral Height ◽

Compression Fractures ◽

Vas Score

Abstract Objective To investigate the early clinical effect of vesselplasty and percutaneous vertebroplasty in the treatment of elderly patients osteoporotic vertebral compression fractures. MethodsA retrospective analysis was performed on 22 patients (10 males and 12 females, aged 60~85 years old （73.1±9.6）with osteoporosis fracture treated by vesselplasty in Shanxi Bethune Hospital from March 2017 to December 2018..During the same period, 56 patients (20 males and 36 females, aged 60-80 years (70.3±9.4) were treated with percutaneous vertebroplasty (PVP) for osteoporosis fractures.Preoperative and postoperative Visual Analogue Score (VAS), operative time, intraoperative bone cement leakage, preoperative and postoperative vertebral body anterior margin height were recorded to evaluate the clinical efficacy.ResultsIn the vesselplasty group, preoperative VAS score was 7.9±0.9, postoperative VAS score was 3.8±0.8, postoperative recovery rate of vertebral height was 19.9%±19.1%, operative time (33.6±6.2)min, and bone cement leakage was observed in 3 cases.In the PVP group,preoperative VAS score was 7.9±0.9, postoperative VAS score was 3.7±0.8, postoperative recovery rate of vertebral height was 18.8%±18.2%, operative time (35.8±6.6)min, and bone cement leakage was observed in 15 cases.Compared with the PVP group（26.8%, the bone cement leakage rate of the vesselplasty group （13.6%）was significantly reduced, and the difference was statistically significant, but there was no significant difference in other data. ConclusionBoth vesselplasty and percutaneous vertebroplasty can achieve satisfactory early clinical efficacy in the treatment of senile osteoporosis vertebral compression fractures. Bone cement leakage rate of vesselplasty is smaller and it is safer.

Download Full-text

Comparison of unilateral and bilateral percutaneous vertebroplasty in the treatment of severe vertebral compression fractures

10.21203/rs.3.rs-22865/v1 ◽

2020 ◽

Author(s):

Juan Long ◽

Chun Jing He ◽

Zikun Duan ◽

Xinguo Kang ◽

Jinfeng Zou

Keyword(s):

Bone Cement ◽

Percutaneous Vertebroplasty ◽

Operation Time ◽

Cement Leakage ◽

Vertebral Compression Fractures ◽

Compression Fractures ◽

Needle Position ◽

Relieve Pain ◽

Group A ◽

Group B

Abstract BACKGROUND The purpose of this study was to comparison of unilateral and bilateral percutaneous vertebroplasty in the treatment of severe vertebral compression fractures. METHODS Sixty-four severe vertebral compression fractures patients were treated in our hospital were randomly divided into group A and group B(n = 32). Group A received Percutaneous vertebroplasty (PVP) treatment by unilateral vertebral pedicle approach. Group B received PVP treatment by bilateral vertebralpedicle approach. Visual Analogue scale (VAS) score and Oswesty Disability Index (ODI) were recorded before surgery, and at 1d,1 month, and 6 months after operation. Also, the puncture path, needle position, intraoperative bone cement injection volume, bone cement dispersion, intra-operative and postoperative complications were observed. RESULTS Sixty-four vertebrae were successfully punctured.The postoperative VAS,ODI were lower than preoperative, showed statistical difference compared with the preoperative VAS, ODI, but there are no difference between Group A and Group B.The cement leakage and operation time is lower in group A than that in Group B. CONCLUSION PVP by unilateral vertebral pedicle approach in treating severe vertebral compression fractures can significantly relieve pain and promote functional recovery, which has advantages such as convenient operation and low complication rate.

Download Full-text

High-viscosity bone cement for vertebral compression fractures: a prospective study on intravertebral diffusion and leakage of bone cement

10.21203/rs.3.rs-22514/v4 ◽

2020 ◽

Author(s):

Meiyong Wang ◽

Qunhua Jin

Keyword(s):

Diffusion Coefficient ◽

Bone Cement ◽

Statistical Significance ◽

Cement Leakage ◽

High Viscosity ◽

Vertebral Compression Fractures ◽

Injection Time ◽

Time Duration ◽

Compression Fractures ◽

Group B

Abstract Background: Bone cement leakage causes severe complication following percutaneous vertebroplasty. This study probed the diffusion and leakage status of bone cement injected within diverged time duration, so as to find the optimal injection time for bone cement. Methods: A total of 70 patients with osteoporotic vertebral compression fractures with a symptom of low back pain, who underwent treatment at hospital were enrolled in this study. Patients were randomized into three groups: <180 s, 180-300, and >300 s of injection time duration from the beginning to the completion of the injection. The scenarios of vertebral bone cement leakage and diffusion were inspected using postoperative CT.Results: The diffusion coefficient was higher in group A than in group B whereas it was higher in group B than in group C, but without statistical significance among the three groups. The leakage rate was without statistical significance among the three groups. The injection time of bone cement was negatively correlated with the diffusion coefficient, at the correlation coefficient of -0.253. Conclusions: The diffusion coefficient of high-viscosity bone cement is negatively correlated with the injection time, and the leakage rate of high-viscosity bone cement does not reduce with the prolongation of injection time.

Download Full-text