[Balloon-assisted percutaneous vertebroplasty in patients with osteoporotic vertebral body compression fractures--first results].
OBJECTIVE
To determine the feasibility, efficacy and safety of balloon-assisted percutaneous vertebroplasty (BA-VP) in patients with osteoporotic vertebral compression fractures (VCFs).


METHODS
In 47 patients (29 women, 18 men; mean age: 70 years and 4 months) with severe VCFs, 66 BA-VPs were performed via a unipedicular access. After initial puncture (under combined fluoroscopy and CT guidance) of the vertebral body (VB), the needle was retraced by 1.5 cm, and a 12-mm Fogarty balloon catheter was introduced and inflated using 2-4 ml diluted contrast media (CM). After the subsequent removal of the catheter and repositioning of the needle, vertebroplasty was performed.


RESULTS
The mean volume of PMMA injected was 4.4 ml (2.5-7.2 ml). Pain reduction (measured by the Visual Analogue Scale) was achieved in 95 % of the patients, dropping from on average 8.0 pre-intervention to 2.2 after a mean follow-up of 8 months. A reduction of the pain relieving medication was achieved in 68 % of the cases and patient activity improved markedly. No severe or clinically relevant complications were observed. Cement leakage occurred by filling of epidural and paravertebral veins in 9.1 and 6.1 % of the cases, respectively. Leakage into the paravertebral soft tissues was seen in 3.0 % of the patients and to the adjacent disc space in 10.6 % of the cases.


CONCLUSIONS
Vertebroplasty and kyphoplasty are currently used to treat osteoporotic VCFs but show either a comparatively high leakage rate or are rather complex and expensive. Balloon-assisted vertebroplasty seems to combine advantages from both methods and is effective, safe and comparatively inexpensive.
Schulte
B U
BU
Zentralinstitut für bildgebende Diagnostik, Städtisches Klinikum Karlsruhe. Bernhard.Schulte@Klinikum-Karlsruhe.com
Brücher
D
D
Trompeter
M
M
Remy
C
C
Reimer
P
P
D000368:Aged; D001416:Back Pain / Q000209:etiology / Q000517:prevention & control; D002404:Catheterization / Q000379:methods*; D002484:Cementation / Q000379:methods; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D050815:Fractures, Compression / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D010024:Osteoporosis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D010865:Pilot Projects; D011859:Radiography; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome