The Effectiveness of Osteoplasty System (Vertebroplasty using Large Cannula-low Pressure Delivery System) in Compression Fracture and other Spinal Pathology

  • Kang, Jeong-Han (Department of Neurosurgery, Yonsei University College of Medicine, Yongdong Severance Hospital) ;
  • Kuh, Sung-Uk (Department of Neurosurgery, Yonsei University College of Medicine, Yongdong Severance Hospital) ;
  • Shin, Zun-Zae (Department of Neurosurgery, Yonsei University College of Medicine, Yongdong Severance Hospital) ;
  • Cho, Yong-Eun (Department of Neurosurgery, Yonsei University College of Medicine, Yongdong Severance Hospital) ;
  • Yoon, Young-Sul (Department of Neurosurgery, Yonsei University College of Medicine, Yongdong Severance Hospital) ;
  • Chin, Dong-Kyu (Department of Neurosurgery, Yonsei University College of Medicine, Yongdong Severance Hospital)
  • Published : 2005.10.28

Abstract

Objective : The vertebroplasty is an excellent procedure in spine compression fracture, but there are some problems such as cement leakage and difficulties in bone biopsy. Recently, the osteoplasty system is developed to solve these problems, so we will report the usefulness of the osteoplasty system. Methods : From January 2003 to November 2003, there are 9patients with simple osteoporotic spine compression fracture, 2 compression fracture patients combined with suspicious spinal metastasis, 1patient with suspicious primary bone tumor, and 2patient with infection on spine. All patients were treated using the osteoplasty system. Results : All 11 compression fracture patients were relived the back pain after the osteoplasty and there is no complication. The bone biopsies in 3 suspicious cancer patients were also effectively performed using the osteoplasty system; negative result in 2patients and positive result in 1patient. The culture result of spontaneous discitis was no growth for 48hours. The spine tuberculosis was confirm using the osteoplasty system. Conclusion : The osteoplasty system has distinguished advantages in comparison with the vertebroplasty. That is, the risk of cement leakage is lower than vertebroplasty because of low pressure delivery system. And we can obtain the specimen effectively in bone biopsy because of large cannula. In conclusion, we emphasize that the osteoplasty system is a more useful procedure in spine compression fracture especially in the patient needed bone biopsy for diagnosis.

Keywords

References

  1. Barr JD, Barr MS, Lemley TJ, McCann RM : Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 25 : 923-928, 2000 https://doi.org/10.1097/00007632-200004150-00005
  2. Bostrom MP, Lane JM : Future directions. Augmentation of osteoporotic vertebral bodies. Spine 22(Suppl 24) : 38-42, 1997 https://doi.org/10.1097/00007632-199701010-00007
  3. Chen HL, Wong CS, Ho ST, Chang FL, Hsu CH, Wu CT : A lethal pulmonary embolism during percutaneous vertebroplasty. Anesth Analg 95 : 1060-1062, 2002 https://doi.org/10.1097/00000539-200210000-00049
  4. Chiras J, Depriester C, Weill A, Sola-Martinez MT, Deramond H : Percutaneous vertebral surgery. Technics and indications. J Neuroradiol (Fr) 24 : 45-49, 1997
  5. Cotten A, Dewatre F, Cortet B, Assaker R, Leblond D, Duquesnoy B, et al : Percutaneous vertebroplasty for osteolytic metastases and myeloma : effects of the percentage of lesion filling and the leakage of methylmethacrylate at clinical follow-up. Radiology 200 : 525-530, 1996 https://doi.org/10.1148/radiology.200.2.8685351
  6. Deramond H, Depriester C, Galibert P, Le Gars D : Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. Radiol Clin North Am 36 : 533-546, 1998 https://doi.org/10.1016/S0033-8389(05)70042-7
  7. Galibert P, Deramond H, Rosat P, Le Gars D : Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie(Fr) 33 : 166-168, 1987
  8. Jang JS, Lee SH, Jung SK : Pulmonary embolism of polymethylmethacrylate after percutaneous vertebroplasty : a report of three cases. Spine 27 : 416-418, 2002 https://doi.org/10.1097/00007632-200210010-00021
  9. Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion JE : Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures : technical aspects. AJNR Am J Neuroradiol 18 : 1897-1904, 1997
  10. Lee JU, Ryu KS, Park CK, Cho YS, Ji C, Cho KS, et al : Percutaneous Polymethylmethacrylate Vertebroplasty in the Treatment of Osteoporotic Thoracic and Lumbar Vertebral Body Compression Fractures : Outcome of 159Patients. J Korean Neurosurg Soc 30 : 173-179, 2001
  11. Levine SA, Perin LA, Hayes D, Hayes WS : An evidence-based evaluation of percutaneous vertebroplasty. Manag Care 9 : 56-60, 2000
  12. Noh CH, Yi JS, Lee HJ, Yang JH, Lee IW, Kim MC, et al : Effect of percutaneous vertebroplasty with polymethylmethacrylate to osteoporotic spinal compression fractures and bursting fractures. J Korean Neurosurg Soc 35 : 365-371, 2004
  13. Padovani B, Kasriel O, Brunner P, Peretti-Viton P : Pulmonary embolism caused by acrylic cement : a rare complication of percutaneous vertebroplasty. AJNR Am J neuroradiol 20 : 375-377, 1999
  14. Schlaich C, Minne HW, Bruckner T, Wagner G, Gebest HJ, Grunze M, et al : Reduced pulmonary function in patients with spinal osteoporotic fractures. Osteoporos Int 8 : 261-267, 1998 https://doi.org/10.1007/s001980050063
  15. Scroop R, Eskridge J, Britz GW : Paradoxical cerebral arterial embolization of cement during intraoperative vertebroplsty : Case report. AJNR Am J Neuroradiol 23 : 868-870, 2002
  16. Wasnich RD : Vertebral fracture epidemiology. Bone 18(Suppl 3) : 179- 183, 1996 https://doi.org/10.1016/8756-3282(95)00442-4
  17. Yoo KY, Jeong SW, Yoon W, Lee J : Acute respiratory distress syndrome associated with pulmonary cement embolism following percutaneous vertebroplasty with polymethylmethacrylate. Spine 29 : 294-297, 2004 https://doi.org/10.1097/01.BRS.0000131211.87594.B0