Cement Augmentation of Osteoporotic Compression Fractures and Intraoperative Navigation

Abstract

Emerging techniques and technologies in treating spinal disorders appear to be very promising. Vertebroplasty and kyphoplasty are new techniques that have been developed for treating osteoporotic vertebral compression fractures with early promising clinical results. More sophisticated and technically advanced methods of surgical navigation are also being developed as spinal surgery moves toward less invasive or minimally invasive procedures. Cost effectiveness, complication rates, and clinical efficacy need to be better defined to determine the exact role of these emerging techniques and technologies.

Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review

“…Regarding safety, and while acknowledging the important influence of patient age, fragility, and the number of existing comorbidities in the population amenable to treatment with BK, it seems possible to reduce the appearance of complications through the adequate selection of patients, the use of high-quality radiological techniques during insertion of the device, the injection of bone cement in an appropriate state of polymerization, and adequate surgeon training [24,36,54,55]. This latter aspect is of particular importance, for although the procedure is percutaneous, it is also complex and-as reported in the literature-requires skill and experience.…”

“…While BK has been introduced to clinical practice, no firm conclusions have yet been drawn as to the efficacy and safety of the technique [24,36,54]. For this reason, and considering the rate at which the procedure is being diffused and incorporated to clinical practice, the present systematic review aims to analyze the collected body of evidence regarding the efficacy and safety on BK in the treatment of VCFs.…”

Radiation Exposure to the Surgeon During Fluoroscopically Assisted Percutaneous Vertebroplasty

“…[1][2][3][4][5][6][7][8][9][10] The procedure is performed under biplanar fluoroscopic control. Although some authors have recommended computed tomography guidance during cannula placement 11 or computer assisted surgery, 12 cement injection can only be properly controlled by real-time fluoroscopy. With an increasing number of vertebroplasty procedures performed at our institution by the same spine surgeons and a general trend toward increasing intraoperative imaging in the majority of other spine procedures performed, the question of the radiation exposure for a spine surgeon developed.…”

Navigated reconstruction of tibial head depression fractures by inflation osteoplasty

“…On the other hand, treatment of vertebral fractures using kyphoplasty, with or without navigated control, has shown advantages related to its minimally invasive approach [10,16,17]. The use of a balloon for reducing acetabular fractures has been described once as a case report [12].…”