title: [Initial clinical experience with radiofrequency-guided percutaneous vertebral augmentation in the treatment of vertebral compression fractures].
abstract: OBJECTIVE
  Percutaenous Vertebroplasty (PVP) is effective in alleviating pain and facilitating early mobilization following vertebral compression fractures. The relatively high risk of extravertebral leakage due to uncontrolled delivery of low viscosity bone cement is an inherent limitation of the technique. The aim of this research is to investigate the ability of controlled cement delivery in decreasing the rate of such complications by applying radiofrequency heating to regulate cement viscosity.
  
  
  METHODS
  Thirty two vetebrae were treated in 28 patients as part of an Ethics Committee approved multicenter clinical trial using RadioFreqency assisted Percutaenous Vertebral Augmentation (RF-PVA) technique. This technique is injecting low viscosity polymethylmethacrylate (PMMA) bone cement using a pressure controlled hydraulic pump and applying radiofrequency heating to increase cement viscosity prior to entering the vertebral body. All patients were screened for any cement leakage by X-ray and CT scan. The intensity of pain was recorded on a Visual Analog Scale (VAS) and the level of physical activity on the Oswestry Disability Index (ODI) prior to, one day, one month and three months following procedure.
  
  
  RESULTS
  All procedures were technically successful. There were no clinical complication, intraspinal or intraforaminal cement leakage. In nine cases (29%) a small amount of PMMA entered the intervertebral space through the broken end plate. Intensity of pain by VAS was reduced from a mean of 7.0 to 2.5 and physical inactivity dropped on the ODI from 52% to 23% three months following treatment.
  
  
  CONCLUSIONS
  In this small series controlled cement injection using RF-PVA was capable of preventing clinically hazardous extravertebral cement leakage while achieving outcomes similar to that of conventional vertebroplasty.
authors.affiliation: Országos Idegtudományi Intézet, Budapest.
authors.forename: Miklós
authors.initials: M
authors.lastname: Marosfoi
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Kulcsár
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Berentei
authors.forename: István
authors.initials: I
authors.lastname: Gubucz
authors.forename: István
authors.initials: I
authors.lastname: Szikora
mesh_terms: D000328:Adult; D000368:Aged; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D017102:Fracture Healing; D050815:Fractures, Compression / Q000150:complications / Q000601:surgery*; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D016634:Radiosurgery / Q000379:methods*; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*; D014783:Viscosity
chemical_list: D001843:Bone Cements