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CardioVascular and Interventional Radiology

, Volume 31, Issue 5, pp 937–947 | Cite as

Percutaneous Vertebroplasty and Bone Cement Leakage: Clinical Experience with a New High-Viscosity Bone Cement and Delivery System for Vertebral Augmentation in Benign and Malignant Compression Fractures

  • Giovanni Carlo Anselmetti
  • Gregg Zoarski
  • Antonio Manca
  • Salvatore Masala
  • Haris Eminefendic
  • Filippo Russo
  • Daniele Regge
Clinical Investigation

Abstract

The aim of this study was to assess the feasibility of and venous leakage reduction in percutaneous vertebroplasty (PV) using a new high-viscosity bone cement (PMMA). PV has been used effectively for pain relief in osteoporotic and malignant vertebral fractures. Cement extrusion is a common problem and can lead to complications. Sixty patients (52 female; mean age, 72.2 ± 7.2) suffering from osteoporosis (46), malignancy (12), and angiomas (2), divided into two groups (A and B), underwent PV on 190 vertebrae (86 dorsal, 104 lumbar). In Group A, PV with high-viscosity PMMA (Confidence, Disc-O-Tech, Israel) was used. This PMMA was injected by a proprietary delivery system, a hydraulic saline-filled screw injector. In Group B, a standard low-viscosity PMMA was used. Postprocedural CT was carried out to detect PMMA leakages and complications. Fisher’s exact test and Wilcoxon rank test were used to assess significant differences (< 0.05) in leakages and to evaluate the clinical outcome. PV was feasible, achieving good clinical outcome (< 0.0001) without major complications. In Group A, postprocedural CT showed an asymptomatic leak in the venous structures of 8 of 98 (8.2%) treated vertebrae; a discoidal leak occurred in 6 of 98 (6.1%). In Group B, a venous leak was seen in 38 of 92 (41.3%) and a discoidal leak in 12 of 92 (13.0%). Reduction of venous leak obtained by high-viscosity PMMA was highly significant (< 0.0001), whereas this result was not significant (= 0.14) related to the disc. The high-viscosity PMMA system is safe and effective for clinical use, allowing a significant reduction of extravasation rate and, thus, leakage-related complications.

Keywords

Vertebroplasty Cement leakage Spine Vertebral fracture Polymethylmethacrylate Osteoporosis Bone metastases 

Notes

Acknowledgment

The authors acknowledge Mrs. Olga Bruno for her kind and lovely collaboration.

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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Giovanni Carlo Anselmetti
    • 1
  • Gregg Zoarski
    • 2
  • Antonio Manca
    • 3
  • Salvatore Masala
    • 4
  • Haris Eminefendic
    • 3
  • Filippo Russo
    • 3
  • Daniele Regge
    • 3
  1. 1.Interventional Radiology UnitInstitute for Cancer Research and Treatment (IRCC)Candiolo, TurinItaly
  2. 2.Radiology and Radiological ScienceUniversity of MarylandBaltimoreUSA
  3. 3.Radiology UnitInstitute for Cancer Research and Treatment (IRCC)Candiolo, TurinItaly
  4. 4.Radiology Unit and Interventional Radiology UnitUniversity “Tor Vergata”RomeItaly

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