title: Vertebroplasty Using Calcium Triglyceride Bone Cement (Kryptonite™) for Vertebral Compression Fractures. A Single-Centre Preliminary Study of Outcomes at One-Year Follow-up.
abstract: This study assessed the one-year clinical and radiographic outcomes, in terms of pain-relief, vertebral re-fracture and complications, after vertebroplasty (VP) using a new osteoconductive cement (calcium triglyceride bone cement - Kryptonite™ bone cement, Doctors Research Group Inc., Southbury, CT, USA) to treat osteoporotic vertebral compression fractures. Sixteen consecutive osteoporotic patients (12 women and four men, mean age 68+/-10.5) were treated with VP using Kryptonite™ bone cement for a total of 20 vertebral fractures. All the patients complained of a pain syndrome resistant to medical therapy and all procedures were performed under fluoroscopy control with neuroleptoanalgesia using a monopedicular approach in 12 patients and bipedicular approach in four patients. All patients were studied by MR and MDCT and were evaluated with the visual analogue scale (VAS) and the Oswestry disability index (ODI) before treatment and at one and 12 months after the procedure. A successful outcome was observed in 80% of patients, with a complete resolution of pain. Differences in pre and post treatment VAS and ODI at one-year follow-up were significant (P<0.0001). We observed a disk and venous leakage in 66% of patients but only in one case did an asymptomatic pulmonary embolism occur during cement injection. Two cases of vertebral re-fractures at distant metamers were observed during follow-up. VP using Kryptonite bone cement is a helpful procedure that allows complete and long-lasting resolution of painful vertebral symptoms. The cost of the material is very high and the rate of disk and venous leakage is too high compared to standard cement.
authors.affiliation: Neuroradiology Service, Cardarelli Hospital; Naples, Italy - gianluigiguarnieri@hotmail.it.
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Guarnieri
authors.affiliation: Radiology Service, Seconda Università degli Studi di Napoli SUN; Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Tecame
authors.affiliation: Neuroradiology Service, Cardarelli Hospital; Naples, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Izzo
authors.affiliation: Neuroradiology Service, Cardarelli Hospital; Naples, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Vassallo
authors.affiliation: Radiology Service, Seconda Università degli Studi di Napoli SUN; Naples, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Sardaro
authors.affiliation: Radiology Service, Seconda Università degli Studi di Napoli SUN; Naples, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Iasiello
authors.affiliation: Neuroradiology Service, Cardarelli Hospital; Naples, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Cavaliere
authors.affiliation: Neuroradiology Service, Cardarelli Hospital; Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Muto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements; D002368:Castor Oil / Q000009:adverse effects / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000601:surgery; D010146:Pain / Q000209:etiology / Q000601:surgery; D010147:Pain Measurement; D011108:Polymers / Q000009:adverse effects / Q000191:economics; D011183:Postoperative Complications / Q000453:epidemiology; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery*; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*
chemical_list: D001843:Bone Cements; C552291:Kryptonite bone cement; D011108:Polymers; D002368:Castor Oil
keywords: bioactive osteoconductive cement; calcium triglyceride bone cement; leakage rate; vertebral re-fracture; vertebroplasty