title: Kummel disease treatment by unipedicular vertebral augmentation using curved injection cannula.
abstract: 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.
authors.affiliation: Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University Tor Vergata, Viale Oxford 81, Rome, Italy. salva.masala@tiscali.it
authors.forename: Salvatore
authors.initials: S
authors.lastname: Masala
authors.forename: Giovanni
authors.initials: G
authors.lastname: Nano
authors.forename: Matteo
authors.initials: M
authors.lastname: Mammucari
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simonetti
mesh_terms: 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*
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate