The effects of cement volume on clinical outcomes of percutaneous vertebroplasty.
OBJECTIVE
There exists significant variability in the volume of polymethylmethacrylate cement injected during percutaneous vertebroplasty. Larger cement volumes injected may be associated with better clinical outcomes, but larger volumes may also be associated with greater risk of complications related to cement leakage. We describe an analysis of the association between clinical and procedural variables, including cement volume injected, and the clinical outcomes of patients treated with single-level vertebroplasty.


METHODS
Retrospective analysis of 158 patients treated with single-level vertebroplasty was performed. Relationships among patient and procedural variables and relationships between these variables and ordinal clinical outcome scores of pain and medication use at postprocedure time points from 1 week to 2 years were evaluated with bivariate and multivariable analyses.


RESULTS
There was no significant association between the volume of cement injected and the clinical outcomes of postprocedure pain (P = .159-.871) and medication use (P = .223-.875).


CONCLUSIONS
Vertebroplasty operators need not feel compelled to achieve particular cement volumes injected in the pursuit of better clinical outcomes but should strive to achieve the maximal safe filling of individual vertebral bodies.
Kaufmann
T J
TJ
Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA. kaufmann.timothy@mayo.edu
Trout
A T
AT
Kallmes
D F
DF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000209:etiology; D001843:Bone Cements / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000209:etiology; D005260:Female; D005471:Fluoroscopy; D050815:Fractures, Compression / Q000628:therapy*; D006801:Humans; D007278:Injections, Spinal; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000150:complications / Q000628:therapy; D010043:Outcome and Process Assessment, Health Care; D010147:Pain Measurement; D019904:Polymethyl Methacrylate / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000628:therapy*; D013904:Thoracic Vertebrae / Q000187:drug effects / Q000293:injuries*
D001843:Bone Cements; D019904:Polymethyl Methacrylate