Eficacia y seguridad a largo plazo del polimetilmetacrilato (PMMA) en pacientes osteoporóticos tratados mediante vertebroplastia percutánea

Abstract

Objetive: Currently, there are limited data on the long-term influence of polymethylmethacrylate (PMMA) on the integrity of vertebral bodies after percutaneous vertebroplasty (PVP). Interesting investigation is being carried out into the possible relationship between this technique and the appearance over time of osteolytic phenomena or cement fragmentation in the intervened vertebrae. The objective of our study was to investigate whether there is a loss of effectiveness and/or safety of PVP with PMMA in the long term. Material and methods: X-rays were analyzed of intervened patients corresponding to the immediate post-operative and the most recent radiological study (PVP more than 15 years previous). With both radiological studies, we describe: the height of the vertebral body, the angulation of lamellar plates and osteolytic presence around the cement over time. Results: A total of 7 patients operated by PVP with PMMA 15 or more years earlier agreed to have a new radiograph in our center. After the analysis of their post-operative images (immediate and 15 or more years after surgery), no loss of height of the cemented vertebral body, differences in angulation in the lamellar plates, presence of osteolysis around the vertebrae was observed in any of the involved vertebrae cement or fragmentation of the injected PMMA. Conclusion: PMMA injected into the vertebral body remains stable over time (more than 15 years). There are no changes in the bone-PMMA interface, osteolysis and/or changes in the height of the vertebral bodies in the cases analyzed.

Calidad de vida en mujeres mayores de 65 años diagnosticadas de osteoporosis

“…En la actualidad existen controversia sobre su utilización debido a la aparición con el tiempo de fenómenos de osteólisis o la fragmentación del cemento en las vértebras intervenidas . (124) La cifoplastia con balón es un procedimiento quirúrgico que implica el inflado de un globo en la zona de una fractura vertebral y luego llenar la cavidad creada por el balón con cemento óseo. La finalidad es la misma que en la vertebroplastia, con la ventaja añadida de la dificultad de migración del cemento.…”