Percutaneous cement injection into a created cavity for the treatment of vertebral body fracture: preliminary results of a new vertebroplasty technique

Clin J Pain. 2006 Feb;22(2):182-9. doi: 10.1097/01.ajp.0000169675.41815.49.

Abstract

Objectives: Vertebral body fractures (VBFs) are the most common complication of osteoporosis. Minimally invasive placement of cement to stabilize VBFs results in significant pain reduction and improved performance of daily activities. The authors describe a modified percutaneous vertebroplasty (PV) procedure during which a cavity is created manually in the VBF, allowing the cement to be injected with less resistance.

Methods: Data were gathered from a retrospective chart review from 15 consecutive patients with acute compression VBFs who underwent 33 PV procedures with the Cavity Creation System. Mean follow-up was 30 weeks. Oral opiate intake, quality of life improvement, and visual analog pain scores (VAS) were measured before and 1 month after the procedure.

Results: All 15 patients exhibited a reduction in pain VAS (mean reduction 5.9 +/- 2.5). Improvement in quality of life was demonstrated by lower (improved) FACIT scores in the General Activity, Enjoyment of Life, Mood, Normal Work Routine, and Sleep subscales. In addition, opioid use decreased in 10 of the 12 (83%) patients who were taking opioids before surgery. In eight (67%) patients, opioid use decreased by over 50%. Complications included extrusion of cement in two patients (an incidence of 5.7% of the levels operated) and two patients with intraoperative rib fractures. No postoperative neurologic deficits were noted.

Conclusions: The Cavity Creation System is a safe, cost-effective treatment of VBF resulting in good/excellent pain relief and an improved quality of life.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Ambulatory Surgical Procedures / adverse effects
  • Ambulatory Surgical Procedures / methods*
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / therapeutic use
  • Antibiotic Prophylaxis
  • Bone Cements / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Orthopedic Procedures / adverse effects
  • Orthopedic Procedures / methods*
  • Pain / epidemiology
  • Pain / etiology
  • Pain Measurement
  • Pain, Postoperative / epidemiology
  • Quality of Life
  • Retrospective Studies
  • Spinal Injuries / complications
  • Spinal Injuries / therapy*
  • Treatment Outcome

Substances

  • Analgesics, Opioid
  • Bone Cements