title: The safety and effectiveness of a curved needle for vertebral augmentation: comparison with traditional techniques.
abstract: OBJECTIVE
  To evaluate the safety and effectiveness of a curved needle compared with traditional (noncurved needle) techniques in a large single-center experience.
  
  
  METHODS
  This study was a retrospective analysis of 243 consecutive vertebral augmentation procedures over a 17-month period. Curved needle procedures were compared with noncurved needle procedures for baseline clinical variables, complication rate, pain relief, and improvement in disability. Procedure duration and fluoroscopy time were compared between the two cohorts.
  
  
  RESULTS
  Between curved needle and noncurved needle procedures, there were no statistically significant differences in the baseline clinical variables, fracture location, and fracture etiology. No complications were noted in either group. In both groups, there was a median improvement in the visual analog scale (VAS) score of 2.0 points (P = .62). More than 90% of procedures in both groups resulted in some pain improvement (P = .78). For both groups, the median improvement in disability on the Roland Morris Disability Questionnaire (RMDQ) was 4.0 points (P = .69). Approximately 70% of procedures in both groups resulted in improvement in disability (P = 1.00). In single-level cases, there were shorter procedure times (51.8 min ± 2.7 vs 62.8 min ± 2.2, P = .002) and shorter fluoroscopy times (P = .31) for curved needle procedures.
  
  
  CONCLUSIONS
  The curved needle is as safe and effective as traditional vertebral augmentation techniques in treating the pain and disability related to vertebral compression fractures. Additionally, the curved needle is associated with shorter procedure duration and reduced fluoroscopy time.
authors.affiliation: Division of Interventional Neuroradiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Gray 241, Boston, MA 02114, USA.
authors.forename: Akriti
authors.initials: A
authors.lastname: Saxena
authors.forename: Reza
authors.initials: R
authors.lastname: Hakimelahi
authors.forename: Ruchira M
authors.initials: RM
authors.lastname: Jha
authors.forename: Ariel E
authors.initials: AE
authors.lastname: Hirsch
authors.forename: Marion
authors.initials: M
authors.lastname: Growney
authors.forename: Albert J
authors.initials: AJ
authors.lastname: Yoo
mesh_terms: D000368:Aged; D001900:Boston / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D050815:Fractures, Compression / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D009339:Needles / Q000706:statistics & numerical data*; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D018570:Risk Assessment; D012307:Risk Factors; D016103:Spinal Fractures / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000295:instrumentation* / Q000706:statistics & numerical data*