Balloon Kyphoplasty for Vertebra Plana with or without Osteonecrosis

Abstract

Purpose. To compare efficacy of balloon kyphoplasty in restoring vertebral height and correcting kyphosis in patients having vertebra plana with or without osteonecrosis. Methods. 12 women and 3 men (mean age, 76 years), who had a complete vertebra plana with or without osteonecrosis (n=8 vs n=7), underwent balloon kyphoplasty. No external manoeuvres were performed before or during balloon kyphoplasty, except for positioning the patients in a prone posture on the operating table. The anterior, middle, and posterior vertebral height and the kyphotic angle were measured pre-and post-operatively with a digital imaging system. The vertebral height was measured as a percentage of the adjacent normal vertebral height. Results. Respectively in vertebra plana patients with or without osteonecrosis, the mean corrections of (1) kyphosis were 10º and 4º (p=0.099), (2) anterior vertebral height were 33% and 5% (p<0.001), (3) middle vertebral height were 38% and 18% (p=0.004), and (4) posterior vertebral height were 19% and 2% (p=0.031).

Cement Filling Control and Bone Marrow Removal in Vertebral Body Augmentation by Unipedicular Aspiration Technique

“…15 The proposed unipedicular aspiration technique may also prove usefulness for the aspiration of cancerous tissue in hematoma or seroma. However, some changes in the cannula design will be required to allow for the aspiration of such thick tissue.…”

Kyphoplasty for the treatment of malignant vertebral compression fractures caused by metastases

“…Kyphoplasty is now a commonly used and effective treatment option for alleviating pain, with the inflatable bone tamp able to reduce the collapsed vertebrae, increase vertebral height, reduce kyphotic deformity, minimize cement leakage and allow the performance of bone biopsy. 22 Although it does not improve the survival outcomes of patients with metastases, palliation is a reasonable goal when life expectancy is short, and treatment of vertebral fractures can reduce the incidence of complications associated with longterm bed rest, which may be particularly relevant for older patients. Therefore, kyphoplasty in the treatment of malignant vertebral compression fractures caused by metastases should be considered because it may provide rapid pain relief and vertebral stabilization, and stop the progression of VB deformity.…”

Low Volume Vertebral Augmentation with Cortoss® Cement for Treatment of High Degree Vertebral Compression Fractures and Vertebra Plana

“…During the widespread use of balloon kyphoplasty in the 1990’s, the assumption evolved that treatment needed to be bilateral and required larger volumes of cement, alongside the usage of expanded balloons, to attempt vertebral height restoration and vertebral angulation correction for pain relief [1, 6]. Contrary to this belief, height may only be restored in a limited percentage of acute or subacute fractures.…”

“…The post-procedure restoration of height and kyphotic correction was limited and often not maintained with weight-bearing. There was also an association with a significant incidence of cement leakage and balloon breakage during the time of the procedure [1, 6]. Additionally, there does not exist a clear reported correlation between vertebral height correction and pain relief.…”

“…Additionally, there does not exist a clear reported correlation between vertebral height correction and pain relief. Several authors have raised the concern that rigidity from large cement volumes leads to a higher rate of adjacent level fracture [1, 6]. …”