OUTCOME OF VERTEBROPLASTY USING CALCIUM PHOSPHATE CEMENT FOR OSTEOPOROTIC VERTEBRAL FRACTURES WITH MIDDLE COLUMN DESTRUCTION ???COMPARISON BETWEEN VARTEBROPLASTY AND CONSERVATIVE THERAPY-

Object. Osteoporotic vertebral fractures occasionally lead to late-onset collapse, kyphosis, persistent back pain, and disability. The authors describe a series of patients in whom they performed percutaneous vertebroplasty by using calcium phosphate cement (CPC) to obtain early pain relief and improve the integrity of the osteoporotic vertebral body (VB). Methods. Between August 2000 and February 2001, they performed 17 percutaneous transpedicular CPC-assisted vertebroplasty procedures in 16 patients who harbored thoracic or lumbar osteoporotic vertebral fractures. Following repositioning and curettage of the pathological soft tissues, CPC-assisted vertebroplasty was percutaneously performed in four patients with osteoporotic burst fracture and pseudarthrosis (Procedure A). In situ CPC-assisted vertebroplasty was performed in 12 patients with fresh vertebral compression fractures due to osteoporosis (Procedure B). Back pain and low-back pain were evaluated using a visual analog scale (VAS). The deformity index of the VB was measured on a lateral radiograph as the ratio of the VB's height (sum of measurements at anterior, middle, and posterior regions) to its longitudinal diameter. Based on VAS scores, pain was decreased in all patients immediately after surgery, and pain relief was maintained at the last follow up. The mean preoperative deformity index score of the VB was 1.43 in Procedure A and 1.67 in Procedure B; postoperatively scores improved to 1.59 and 1.93, respectively. At the 6-month follow-up examination, the mean deformity index score rebounded to 1.52 in Procedure A and 1.79 in Procedure B. Bone union was documented in all patients. Complications, such as a temporary respiratory insufficiency and a small amount of CPC leakage into the spinal canal, were observed in patients who underwent Procedure B. Conclusions. Percutaneous transpedicular CPC-assisted vertebroplasty is a minimally invasive procedure that provides early relief of pain and prevents vertebral collapse and pseudarthrosis in patients with osteoporotic vertebral fracture.

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percutaneous vertebroplasty with calcium phosphate cement for osteoporotic vertebral fractures: Indication, surgical techniques, clinical results, and complications

The Journal of Japanese Society of Lumbar Spine Disorders ◽

10.3753/yotsu.12.91 ◽

2006 ◽

Vol 12 (1) ◽

pp. 91-98 ◽

Cited By ~ 1

Author(s):

Masato NAKANO

Keyword(s):

Calcium Phosphate ◽

Vertebral Fractures ◽

Calcium Phosphate Cement ◽

Percutaneous Vertebroplasty ◽

Surgical Techniques ◽

Clinical Results ◽

Osteoporotic Vertebral Fractures

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5:5058. Surgical Complications and Safety in Mini-Open Transpedicular Vertebroplasty Using Calcium Phosphate Cement for Osteoporotic Vertebral Fractures

The Spine Journal ◽

10.1016/j.spinee.2006.06.080 ◽

2006 ◽

Vol 6 (5) ◽

pp. 29S-30S ◽

Cited By ~ 1

Author(s):

Ryuichi Takemasa ◽

Toshikazu Tani ◽

Katsuhito Kiyasu ◽

Hiroshi Yamamoto

Keyword(s):

Calcium Phosphate ◽

Vertebral Fractures ◽

Calcium Phosphate Cement ◽

Surgical Complications ◽

Osteoporotic Vertebral Fractures ◽

Mini Open

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Calcium phosphate cement leakage after percutaneous vertebroplasty for osteoporotic vertebral fractures: risk factor analysis for cement leakage

Journal of Neurosurgery Spine ◽

10.3171/spi.2005.2.1.0027 ◽

2005 ◽

Vol 2 (1) ◽

pp. 27-33 ◽

Cited By ~ 39

Author(s):

Masato Nakano ◽

Norikazu Hirano ◽

Hirokazu Ishihara ◽

Yoshiharu Kawaguchi ◽

Kousou Matsuura

Keyword(s):

Calcium Phosphate ◽

Epidural Space ◽

Vertebral Fractures ◽

Calcium Phosphate Cement ◽

Cement Leakage ◽

Therapeutic Effects ◽

Content Type ◽

Female Sex ◽

Osteoporotic Vertebral Fractures ◽

Fine Print

Object. The purpose of this study was to analyze the risk factors for leakage of calcium phosphate cement (CPC) after vertebroplasty for osteoporotic vertebral fractures and to determine whether the vertebral body (VB) leakage caused any changes in the therapeutic benefits. Methods. Between August 2000 and April 2002, the authors performed 65 CPC-assisted vertebroplasty procedures in 55 patients with thoracic or lumbar osteoporotic vertebral fractures. Back and low-back pain were evaluated using the visual analog scale and the duration of analgesic medication requirement. Factors related to CPC leakage and the postoperative outcome were analyzed. There was a small amount of VB CPC leakage in 23 cases. In 10 of 23 cases, leakage into the epidural space was found. Although VB CPC leakage was independently associated with high initial age, female sex, high bone mineral density (BMD), short injury—surgery interval, and injection via the unipedicular route in the logistic regression analysis, there was no factor associated with CPC leakage into the epidural space. Cement leakage into the epidural space reduced the immediate therapeutic effects on fracture-related pain (p = 0.0128). All patients in whom cement leaked into the epidural space had improved by the 2-week follow-up examination. Conclusions. Advanced initial age, female sex, high BMD, a short interval from injury to surgery, and injection via the unipedicular route may increase the incidence of CPC leakage. Cement leakage into the epidural space attenuated only the immediate therapeutic effects of CPC-assisted vertebroplasty.

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