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Intravertebral pressure gradient during vertebroplasty

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Abstract

Objective

Intravertebral pressure (IP) is considered a possible factor influencing cement leakage in vertebroplasty (VP). Reports of measuring IP during the injection of the cement reveal rather low values in the periphery of the vertebral body but fail to determine the situation in the center. Hypothesizing there is a significant IP gradient between both areas intravertebral pressure measurements were conducted in a comparative biomechanical study.

Methods

VP was performed in ten lumbar cadaveric spines. A pressure sensor was either placed in the center or in the periphery of the vertebral body, while bone cement was delivered in 1.5-cc increments. Volume flow, cement mixing time, and room temperature were standardized and kept constant during cement injection.

Results

During the administration of the first 1.5 cc of bone cement, the central IP (C-IP) increased to 23.6 kPa and the peripheral IP (P-IP) to 0.9 kPa on average. With the second injection, the mean C-IP was 42.8 kPa while the mean P-IP was 3.8 kPa. During the 3rd filling, C-IP averaged 69.9 kPa and P-IP 12.8 kPa, respectively. At the last increment, C-IP was at 70.7 kPa and P-IP at 24.5 kPa on average.

Conclusions

A centroperipheral IP gradient (∆IP) was monitored during cement delivery in VP. ∆IP decreases with increasing bone cement charge of the vertebra, but C-IP stays significantly higher than P-IP at all times. C-IP was consistently higher than IP values reported for VP so far.

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Authors and Affiliations

  1. Department of Spine Surgery, Dillingen Wertingen Hospitals, Ebersberg 36, 86637, Wertingen, Germany

    Markus Weisskopf

  2. Department for Comprehensive Orthopedics & Traumatology, Berlin, Germany

    Oliver Miltner

  3. Department of Orthopaedic Surgery, University Medical Centre, Mainz, Germany

    Uwe Maus

  4. Department of Orthopaedic and Trauma Surgery, University Hospital Bonn, Bonn, Germany

    Sascha Gravius

  5. Department of Orthopaedic Surgery, University Hospital, RWTH Aachen, Aachen, Germany

    Jörg Axel Karl Ohnsorge

Authors
  1. Markus Weisskopf
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  2. Oliver Miltner
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  3. Uwe Maus
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  4. Sascha Gravius
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  5. Jörg Axel Karl Ohnsorge
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Correspondence to Markus Weisskopf.

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Weisskopf, M., Miltner, O., Maus, U. et al. Intravertebral pressure gradient during vertebroplasty. Skeletal Radiol 42, 79–84 (2013). https://doi.org/10.1007/s00256-012-1450-1

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  • DOI: https://doi.org/10.1007/s00256-012-1450-1

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