title: CT fluoroscopy-guided vertebral augmentation with a radiofrequency-induced, high-viscosity bone cement (StabiliT(®)): technical results and polymethylmethacrylate leakages in 25 patients.
abstract: OBJECTIVE
  To assess the technical results of CT fluoroscopy-guided, radiofrequency-induced vertebral augmentation (StabiliT®) in terms of vertebral height restoration and polymethylmethacrylate (PMMA) leakages, occurring in 25 individual patients with vertebral compression fractures and osteolysis.
  
  
  METHODS
  From 07/2010 to 08/2011, 25 patients (16 women, nine men; age 71 ± 14; range 41-89) with painful vertebral compression fractures due to osteoporosis (n = 19), metastases (n = 2) or multiple myeloma (n = 4) underwent vertebral augmentation with a radiofrequency-activated, high-viscosity polymethylmethacrylate (PMMA) bone cement (StabiliT® Vertebral Augmentation system; DFINE Europe GmbH, Mannheim) under local anesthesia. Thirty-four vertebrae (Th5-L5) were treated in 27 sessions under CT fluoroscopy guidance (128-row CT, Somatom Definition AS, Siemens, Erlangen) using a unilateral access and a cavity-creating osteotome prior to remote-controlled, hydraulically driven cement injection. 1/2/3 levels were treated in 21/5/1 session(s). Vertebral height change in the midsagittal plane (anterior, midvertebral, posterior endplate distance) and PMMA leaks were retrospectively evaluated using the postinterventional CT.
  
  
  RESULTS
  All patients were successfully treated in the first session. Mean (MV ± SD) procedure time and amount of injected PMMA were 56 ± 14 min and 4.5 ± 1.4 ml, respectively. Mean anterior/midvertebral/posterior height gain was +7.1/+9.7/+0.4%. Small local vertebral leaks were observed in 18/34 vertebrae (53%) without any clinical sequelae. No major complications occurred.
  
  
  CONCLUSIONS
  CT fluoroscopy-guided, RF-induced vertebral augmentation with a high-viscosity bone cement (StabiliT®) was safe and technically successful in all patients. Using a hydraulic cement injection technique, a moderate restoration of anterior and midvertebral height was seen while the system was not markedly superior to standard vertebroplasty regarding the frequency of minor asymptomatic PMMA leaks.
authors.affiliation: Department of Clinical Radiology, Klinikum der Ludwig-Maximilians-Universität München-Grosshadern, Marchioninistr. 15, 81377, München, Germany. christoph.trumm@med.lmu.de
authors.forename: Christoph Gregor
authors.initials: CG
authors.lastname: Trumm
authors.forename: Tobias F
authors.initials: TF
authors.lastname: Jakobs
authors.forename: Robert
authors.initials: R
authors.lastname: Stahl
authors.forename: Torleif A
authors.initials: TA
authors.lastname: Sandner
authors.forename: Philipp M
authors.initials: PM
authors.lastname: Paprottka
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
authors.forename: Christoph J
authors.initials: CJ
authors.lastname: Zech
authors.forename: Ralf-Thorsten
authors.initials: RT
authors.lastname: Hoffmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000627:therapeutic use*; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D005471:Fluoroscopy; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate / Q000627:therapeutic use*; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate