Kummel disease treatment by unipedicular vertebral augmentation using curved injection cannula.
OBJECTIVE
This study was designed to evaluate the efficacy of the blunt-tipped curved injection needle (BCN) AVAflex (Care Fusion) for vertebral augmentation in cases of Kummel's disease.


METHODS
We performed 25 vertebral augmentation procedures on 25 consecutive patients (11 men/14 women; mean age, 67 years) with Kummel's disease using the blunt-tipped curved injection needle with PMMA cement. We performed all 25 procedures by unipedicular left approach with patients in prone position under local anesthesia and mild sedation. In all cases, an intravertebral cleft was evident on preprocedural imaging. We evaluated pain intensities by Visual Analogic Scale (VAS) before and at first day, 6 months, and 1 year after procedure.


RESULTS
In all cases the curved injection cannula permitted the filling of the clefts and surrounding cancellous bone without any complication. A significant reduction of kyphotic deformities of the treated vertebral bodies was evident. A significance decrease in VAS values at 1 year also was evident (mean decrease 7.2). At plain dynamic postprocedural X-rays checks, there was no sign of pathologic intravertebral motion as evidence of optimal stabilization.


CONCLUSIONS
BCN AVAflex is a safe and effective device for targeted vertebral augmentation in cases of Kummel's disease. Its distinctive characteristic is the curved injection cannula, which enables targeting the cement injection to areas far off the trajectory of the straight access cannula, thus providing excellent cement spread throughout the entire volume of vertebral body.
Masala
Salvatore
S
Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University Tor Vergata, Viale Oxford 81, Rome, Italy. salva.masala@tiscali.it
Nano
Giovanni
G
Mammucari
Matteo
M
Simonetti
Giovanni
G
D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D050815:Fractures, Compression / Q000150:complications / Q000628:therapy*; D006801:Humans; D007267:Injections / Q000295:instrumentation; D007738:Kyphosis / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009339:Needles; D010020:Osteonecrosis / Q000209:etiology; D058866:Osteoporotic Fractures / Q000150:complications / Q000628:therapy*; D010147:Pain Measurement; D019904:Polymethyl Methacrylate / Q000008:administration & dosage*; D013122:Spinal Diseases / Q000209:etiology / Q000628:therapy*; D016103:Spinal Fractures / Q000150:complications / Q000628:therapy*
D001843:Bone Cements; D019904:Polymethyl Methacrylate