CT/X-Ray-Guided Augmentation Techniques in Lumbar Spine
Augmentation techniques (AT) include different percutaneous mini-invasive procedures such as vertebroplasty (VP) and assisted technique (AT) (kyphoplasty or kyphoplasty-like technique) for the treatment of symptomatic vertebral compression fractures (VCFs) due to osteoporosis diseases, primary or secondary vertebral tumors, and vertebral trauma. The major target of all those techniques is pain relief, thanks to the simple cement injection (polymethylmethacrylate, PMMA) in the collapsed or abnormal soma stabilizing the movements of the trabecular and spongious microfractures (responsible for the pain), making more compact and resistant the vertebral body, improving life quality. While VP consists in the simple cement injection, AT combines this analgesic and vertebral consolidation effect with the restoration of the physiological height of the collapsed vertebral body, reducing the kyphotic deformity and improving vertebral statics and trying to restore the physiologic curvature and biomechanics. Reduction of the kyphotic deformity is the major target of all AT, thanks to the capacity of the system to restore the vertebral height. The aim of this chapter is to explain indication/contraindication treatment, limits, and benefits of the different devices developed by the industry for obtaining vertebral augmentation effect.
KeywordsVertebroplasty Assisted technique-vertebroplasty Kyphoplasty Kyphoplasty-like technique Vertebral compression fracture Spinal metastasis Hemangioma Osteoporosis vertebral fracture Polymethylmethacrylate
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