Complications of percutaneous vertebroplasty and their prevention

Laredo, Jean‐Denis; Hamzé, B.

doi:10.1007/s00256-004-0776-8

Cited by 151 publications

(59 citation statements)

References 30 publications

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“…4). There is consent that the better the visualization, the lower the complication rate [13]. The procedure can of course be performed using single-plane fluoroscopy (Fig.…”

Section: Preprocedural Evaluationmentioning

confidence: 99%

Vertebroplasty in the treatment of osteoporotic vertebral body fracture

et al. 2007

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During the last few years, vertebroplasty has gained a wide acceptance for the treatment of painful osteoporotic vertebral body fractures and osteolytic changes. However, new guidelines with significant changes in indications and technique were published recently in Europe. Therefore, the aim of this review is to highlight recent changes in indications for vertebroplasty, patient work-up and changes in procedural technique, and to give an overview of patient outcome and possible complications. Therefore, technical details like different types of fluoroscopy, needle placement, pain management during the intervention, recommended equipment, including bone cement, and the use of venography are discussed. Postprocedural issues are noted, including the risk of minor and major complications and the expected outcome of the treated patients.

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“…4). There is consent that the better the visualization, the lower the complication rate [13]. The procedure can of course be performed using single-plane fluoroscopy (Fig.…”

Section: Preprocedural Evaluationmentioning

confidence: 99%

Vertebroplasty in the treatment of osteoporotic vertebral body fracture

et al. 2007

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“…However, more than 98% of the leakages are asymptomatic. Only solitary cases of serious complications have been reported in the literature [15,[33][34][35]. Hodler et al divided bone cement leakage into two grades [15]: grade 1 (minor) leakage: the longest diameter of the extravertebral bone-cement collection is less than the longest diameter of the closest pedicle; grade 2 (moderate) leakage: the longest diameter of the extravertebral bone-cement collection is greater than the longest diameter of the closest pedicle, but less than the nearest normal vertebral body.…”

Section: Evaluation Of Complicationsmentioning

confidence: 99%

“…However, more than 98% of the leakages were minor and asymptomatic. Only solitary cases made surgical therapy necessary [15,[33][34][35].…”

Section: Complicationsmentioning

confidence: 99%

Percutaneous vertebroplasty in the therapy of osteoporotic vertebral compression fractures: a critical review

et al. 2006

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Percutaneous vertebroplasty has become an efficient technique for the treatment of painful vertebral fractures. Osteoporotic vertebral compression fractures are characterized by severe back pain and immobilization causing other complications like thrombosis or pneumonia. Vertebral cement augmentation provides increased strength of the vertebral body and an obvious pain relief. Between 1989 and 2004, 30 studies and a total of 2,086 treated patients have been published in literature. A review of these studies has been performed. The number and age of the patients, number of treated vertebrae, pre- and postoperative outcome of pain and complications of the different studies were assessed and analyzed. Percutaneous vertebroplasty is an efficient technique with low complication rates and a significant reduction in pain. It rapidly improves the mobility and quality of life of patients with vertebral compression fractures. With an increasing number of treated patients, experience with this interventional technique has become excellent. But still there are no randomized controlled trials available, showing that percutaneous vertebroplasty has a significantly better outcome than other treatment options, especially after a long-term follow-up.

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“…Percutaneous vertebroplasty, comprising an injection of PMMA into vertebral bodies leads to immediate pain relief in 80-90% of patients [8,10,16]. However, cement leakage is a common occurrence and represents the main complication risk for vertebroplasty [14]. Cement leakage from the vertebral body is reported to be 20-65% [6,10].…”

Section: Introductionmentioning

confidence: 99%

Clinical investigations of polymethylmethacrylate cement viscosity during vertebroplasty and related in vitro measurements

Böger¹,

Wheeler²,

Schenk³

et al. 2009

Eur Spine J

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Percutaneous vertebroplasty, comprising an injection of polymethylmethacrylate (PMMA) into vertebral bodies, is a practical procedure for the stabilization of osteoporotic compression fractures as well as other weakening lesions. Cement leakage is considered to be one of the major and most severe complications during percutaneous vertebroplasty. The viscosity of the material plays a key role in this context. In order to enhance the safety for the patient, a rheometer system was developed to measure the cement viscosity intraoperatively. For this development, it is of great importance to know the proper viscosity to start the procedure determined by experienced surgeons and the relation between the time period when different injection devices are used and the cement viscosity. The purpose of the study was to investigate the viscosity ranges for different injection systems during conventional vertebroplasty. Clinically observed viscosity values and related time periods showed high scattering. In order to get a better understanding of the clinical observations, cement viscosity during hardening at different ambient temperatures and by simulation of the body temperature was investigated in vitro. It could be concluded, that the direct viscosity assessment with a rheometer during vertebroplasty can help clinicians to define a lower threshold viscosity and thereby decrease the risk of leakage and make adjustments to their injection technique in real time. Secondly, the acceleration in hardening of PMMA-based cements at body temperature can be useful in minimizing leakages by addressing them with a short injection break.

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Complications of percutaneous vertebroplasty and their prevention

Cited by 151 publications

References 30 publications

Vertebroplasty in the treatment of osteoporotic vertebral body fracture

Vertebroplasty in the treatment of osteoporotic vertebral body fracture

Percutaneous vertebroplasty in the therapy of osteoporotic vertebral compression fractures: a critical review

Clinical investigations of polymethylmethacrylate cement viscosity during vertebroplasty and related in vitro measurements

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