Modified vertebroplasty using a curved probe: technique and preliminary results.
OBJECTIVE
One of the main limitations of vertebroplasty is the excessive pressure required for injection of sufficient cement into a vertebral body. Kyphoplasty can be used to reduce injection pressure by making a void with a balloon tamp. The author presents a technique of making small voids to reduce cement delivery pressure during vertebroplasty that involves a simple modification of the conventional technique.


METHODS
The author performed this modified vertebroplasty in 48 patients with an acute vertebral compression fracture. Small voids and micro-connections with the fracture gaps in the vertebral body were created using a curved probe placed into the vertebral body through a working cannula. Visual analogue scale (VAS) scores were measured preoperatively and at 1 week and 3 months postoperatively. Forty patients with osteoporotic VCFs were followed for a mean period of 6months.


RESULTS
All 48 patients showed a significant reduction in visual analogue pain scores at 1 week and 3 months postoperatively versus preoperative levels (p<0.001, respectively). No device-related complications or major cement leakages that caused postoperative neurological deficits or pulmonary complications were noted.


CONCLUSIONS
The described modification of vertebroplasty involving the creation of small cavities using a curved probe appears to control cement injection easily during the procedures and minimize cement leakage-related complications.
Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. neuriac@skku.edu
Y J
YJ
Kwon
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000175:diagnosis / Q000601:surgery*; D005598:Fractures, Spontaneous / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation; D016103:Spinal Fractures / Q000175:diagnosis / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D054854:Vertebroplasty / Q000295:instrumentation*