Treating osteoporotic vertebral compression fractures with intraosseous vacuum phenomena using high-viscosity bone cement via bilateral percutaneous vertebroplasty

Guo, Dan; Cai, Jiyang; Zhang, Shengfei; Zhang, Liang; Feng, Xinmin

doi:10.1097/md.0000000000006549

Cited by 11 publications

(13 citation statements)

References 28 publications

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“…It has been worried that low-viscosity cement is prone to leak from the vertebra. However, use of high-viscosity cement does not completely prevent the occurrence of leakage [7][8][9][10][11]. In our practice, it was noticed that cement leakage mostly occurs in the late phase of injection, when the cement viscosity is increasing.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous vertebroplasty with high- versus low-viscosity bone cement for osteoporotic vertebral compression fractures

Mao

Zeng

Wang

et al. 2020

Preprint

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Background: There is no consensus on the best choice between high- and low-viscosity bone cement for percutaneous vertebroplasty (PVP). This study aimed to compare the clinical outcomes and leakage between three cements with different viscosities in treating osteoporotic vertebral compression fractures.Methods: This is a prospective study comparing patients who were treated with PVP: group A (n = 99, 107 vertebrae) with high-viscosity OSTEOPAL V cement, group B (n = 79, 100 vertebrae) with low-viscosity OSTEOPAL V cement, and group C (n = 88, 102 vertebrae) with low-viscosity Eurofix VTP cement. Postoperative pain severity was evaluated using the visual analog scale. Cement leakage was evaluated using radiography and computed tomography.Results: There was no significant difference in the incidence of cement leakage between the three groups (group A 20.6%, group B 24.2%, group C 20.6%, P = 0.767). All three groups showed significant reduction in postoperative pain scores but did not differ significantly in pain scores at postoperative 2 days (group A 2.01 ± 0.62, group B 2.15 ± 0.33, group C 1.92 ± 0.71, P = 0.646). During the 6 months after cement implantation, significantly less reduction in the fractured vertebral body height was noticed in group B and group C than in group A (group A 19.0%, group B 8.1%, group C 7.3%, P = 0.009).Conclusions: Low-viscosity cement has comparable incidence of leakage compared to high-viscosity cement in PVP for osteoporotic vertebral compression fractures. It also can better prevent postoperative loss of vertebral body height.

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Section: Introductionmentioning

confidence: 99%

Percutaneous vertebroplasty with high- versus low-viscosity bone cement for osteoporotic vertebral compression fractures

Mao

Zeng

Wang

et al. 2020

Preprint

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“…have attempted to challenge this contraindication for vertebroplasty in cases of severe VB collapse with no increase in complication rate 2,6,22,31,33) . Some studies suggested that using high-viscosity bone cement 18) or other equipment like sideopening injection cannulas 26) could prevent cement leakage. Others introduced modified techniques of cement injection in patients with vertebra plana 17,18) .…”

Section: Introductionmentioning

confidence: 99%

“…Some studies suggested that using high-viscosity bone cement 18) or other equipment like sideopening injection cannulas 26) could prevent cement leakage. Others introduced modified techniques of cement injection in patients with vertebra plana 17,18) . We also performed a modified technique of cement injection called eggshell method in patients with severe metastatic compression fractures (MCFs).…”

Section: Introductionmentioning

confidence: 99%

Double Sequential Ballooning (Eggshell) Method for Treatment of Severe Metastatic Compression Fractures with Extra-Compartment Involvement: In Comparison with Conventional Balloon Kyphoplasty

Lee

Gwak

Lee

et al. 2018

Nerve

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Severely compressed vertebral fractures with extra-compartment involvement are considered relative contraindications for percutaneous vertebroplasty (PVP) and balloon kyphoplasty (BKP) in the fear of cement leakage or failure in vertebral height restoration. The purpose of the current study was to evaluate the effectiveness of a new technique known as double sequential ballooning (eggshell) method for severe metastatic compression fractures (MCFs) with extra-compartment involvement. Methods: We retrospectively reviewed 118 patients with MCF who underwent BKP between March 2002 and September 2017. Among them, 9 patients underwent BKP using the eggshell method. We analyzed the differences of radiological and clinical results between these 2 patients groups. Results: Patients who underwent BKP using the eggshell method showed a higher frequency of severe compression (p=0.026), and more columns involvement as per 6-column classification (p=0.004) compared with those who underwent conventional BKP. They also showed higher frequency of paravertebral (PV) extension and PV and epidural involvement (p<0.001). The median amount of injected cement was significantly higher in eggshell group compared with conventional BKP (7.5 cc vs. 6 cc; p=0.049), and so, vertebral body (VB) height gain was (4 mm [range. 2-9 mm] vs. 2.5 mm [range, 0-10 mm]; p=0.021). Patients in the eggshell group showed a lower rate of cement leakage, but the difference was statistically insignificant (p=0.273). Conclusion: The eggshell method enabled injection of cement and restoration of vertebral height in patients with severe MCFs with extra-compartment involvement in comparison with conventional BKP. It is expected to reduce cement leakage in these patients.

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“…With the maturity and wide application of this technology, the extravasation of bone cement is mainly prevented by the choice of bone cement material, the improvement of surgical instruments, the dosage and time of bone cement injection [7] . High viscosity bone cement possesses instant high viscosity, low polymerization temperature and can be injected longtime [8] . It can reduce the polymerization effects of bone cement and thermal of bone cement leakage in the PVP treatment, which may greatly improve the safety of PVP, so as to avoid the occurrence of nerve injury and pulmonary embolism.…”

mentioning

confidence: 99%

A Comparative Study on the Treatment of Osteoporotic Vertebral Compression Fracture with Different Injection Volumes of High Viscosity Bone Cement in Percutaneous Vertebroplasty

Song¹,

Shen²,

Yukai³

et al. 2020

pharmaceutical-sciences

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Song et al.: Comparative Treatment of Osteoporotic Vertebral Compression Fracture This study was to compare the clinical effect of different injection volumes of high viscosity bone cement in percutaneous vertebroplasty on the treatment of osteoporotic vertebral compression fractures. One hundred and fifty cases of patients with osteoporotic vertebral compression fractures treated in the Third Affiliated Hospital of Soochow University from January 2017 to October 2018 were enrolled and randomly divided into the high dose group (50 cases), the middle dose group (50 cases) and the low dose group (50 cases) according to the injection volumes of high viscosity bone cement in percutaneous vertebroplasty. There were no significant differences on single vertebral operation time and bleeding volume among the 3 groups. After percutaneous vertebroplasty treatment, the visual analogue score and Oswestry disability index were significantly improved 5 days and 12 months later in all 3 groups. However, no significant differences were found on the visual analogue score and Oswestry disability index among these 3 groups before surgery and 5 days and 12 months later. The vertebral height and Cobb angle of injured vertebrae were significantly improved 5 days and 3 months after operation in the all 3 groups. However, the improvement had no correlation with the dose of high viscosity bone cement. After treatment, there were 14, 9 and 2 cases of bone cement leakage in high dose, middle dose and low dose groups, respectively. The leak rates were 28, 18 and 4 % and there were significant differences among the 3 groups. In conclusion, different injection volumes of high viscosity bone cement in percutaneous vertebroplasty all reached a good effect in the treatment of osteoporotic vertebral compression fractures. And low dose could significantly reduce the leakage of bone cement. Therefore, low dose of high viscosity bone cement could be the first choice for the treatment of osteoporotic vertebral compression fractures for its safety.

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Treating osteoporotic vertebral compression fractures with intraosseous vacuum phenomena using high-viscosity bone cement via bilateral percutaneous vertebroplasty

Cited by 11 publications

References 28 publications

Percutaneous vertebroplasty with high- versus low-viscosity bone cement for osteoporotic vertebral compression fractures

Percutaneous vertebroplasty with high- versus low-viscosity bone cement for osteoporotic vertebral compression fractures

Double Sequential Ballooning (Eggshell) Method for Treatment of Severe Metastatic Compression Fractures with Extra-Compartment Involvement: In Comparison with Conventional Balloon Kyphoplasty

A Comparative Study on the Treatment of Osteoporotic Vertebral Compression Fracture with Different Injection Volumes of High Viscosity Bone Cement in Percutaneous Vertebroplasty

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