Percutaneous cement injection into a created cavity for the treatment of vertebral body fracture: preliminary results of a new vertebroplasty technique.
OBJECTIVE
Vertebral body fractures (VBFs) are the most common complication of osteoporosis. Minimally invasive placement of cement to stabilize VBFs results in significant pain reduction and improved performance of daily activities. The authors describe a modified percutaneous vertebroplasty (PV) procedure during which a cavity is created manually in the VBF, allowing the cement to be injected with less resistance.


METHODS
Data were gathered from a retrospective chart review from 15 consecutive patients with acute compression VBFs who underwent 33 PV procedures with the Cavity Creation System. Mean follow-up was 30 weeks. Oral opiate intake, quality of life improvement, and visual analog pain scores (VAS) were measured before and 1 month after the procedure.


RESULTS
All 15 patients exhibited a reduction in pain VAS (mean reduction 5.9 +/- 2.5). Improvement in quality of life was demonstrated by lower (improved) FACIT scores in the General Activity, Enjoyment of Life, Mood, Normal Work Routine, and Sleep subscales. In addition, opioid use decreased in 10 of the 12 (83%) patients who were taking opioids before surgery. In eight (67%) patients, opioid use decreased by over 50%. Complications included extrusion of cement in two patients (an incidence of 5.7% of the levels operated) and two patients with intraoperative rib fractures. No postoperative neurologic deficits were noted.


CONCLUSIONS
The Cavity Creation System is a safe, cost-effective treatment of VBF resulting in good/excellent pain relief and an improved quality of life.
Vallejo
Ricardo
R
Millennium Pain Center, the Central Illinois Neuroscience Foundation, Bloomington, IL 61701, USA. vallejo1019@yahoo.com
Benyamin
Ramsin
R
Floyd
Bonnie
B
Casto
Joseph M
JM
Joseph
Ninos J
NJ
Mekhail
Nagi
N
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology; D011788:Quality of Life; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D001843:Bone Cements