[CT-guided vertebroplasty and kyphoplasty: comparing technical success rate and complications in 101 cases].
OBJECTIVE
To compare the technical success and complication rates in CT-guided vertebroplasty and kyphoplasty.


METHODS
From 2002 - 2005 69 patients (101 vertebrae) were treated with vertebroplasty (n = 82) or kyphoplasty (n = 19) using 4-slice MSCT with CT fluoroscopy as the sole guidance for the procedure. The underlying lesions were osteoporotic fractures in 78 vertebral bodies and 23 vertebral metastases.


RESULTS
Technical success was achieved in all 101 procedures. Post-interventional CT demonstrated asymptomatic cement leakage in 51/101 vertebrae. Kyphoplasty resulted in leakage in 11/19 (57.9 %) and vertebroplasty in 40/82 (48.8 %) procedures. With p = 0.48 (Mann-Whitney Test) there was no significant difference between kyphoplasty and vertebroplasty with respect to the number of cement leakage occurrences. There was one minor complication of an L5 root irritation following radiofrequency ablation and vertebroplasty of a sarcoma metastasis which subsided without treatment after 8 weeks. There was one major complication of intraspinal cement leakage during tumor vertebroplasty causing T5 root compression and requiring laminectomy for cement removal. The overall rate of major complications requiring treatment was 0.99 %.


CONCLUSIONS
Vertebroplasty and kyphoplasty can be safely performed using only MSCT fluoroscopy guidance. The rate of major complications is very low. There was a high rate of small asymptomatic cement leakages which may have remained undetected with conventional fluoroscopy (CF). There was no statistically significant advantage for kyphoplasty with respect to cement leakage and the technical success rate.
Weber
C H
CH
Institut für klinische Radiologie, LMU München. christof.weber@med.uni-muenchen.de
Krötz
M
M
Hoffmann
R-T
RT
Euler
E
E
Heining
S
S
Pfeifer
K-J
KJ
Reiser
M
M
Linsenmaier
U
U
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000627:therapeutic use*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging; D005260:Female; D005471:Fluoroscopy; D005598:Fractures, Spontaneous / Q000628:therapy*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000628:therapy*; D010024:Osteoporosis / Q000628:therapy*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D015642:Radiology, Interventional; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging; D016103:Spinal Fractures / Q000628:therapy*; D013125:Spinal Neoplasms / Q000556:secondary* / Q000628:therapy; D025321:Surgery, Computer-Assisted; D013904:Thoracic Vertebrae / Q000293:injuries / Q000473:pathology; D036542:Tomography, Spiral Computed
D001843:Bone Cements