Purpose Vertebroplasty is a widely used technique to treat painful osteoporotic vertebral compression fractures but precise control of cement delivery is necessary to minimize the risk of cement leakage. The study is conducted to assess the clinical feasibility of performing vertebroplasty on osteoporotic compression fractures using an ultraviscous cement injected by a hydrolic device, CONFIDENCE Vertebral Augmentation System, to further control cement deposition.
Material and method A retrospective evaluation of a series of 94 consecutively treated patients was identified for the review. There were a total of 163 levels which ranged from T3 to L1 vertebral bodies. The degree of leakage, seen in the postoperative films, was assessed at each treated level using a strict 4 point scale (none, minimal, moderate, severe). The pattern of any observed leakage was also characterized as: distal, venous, paravetebral or epidural.
Results Preoperatively the mean degree of vertebral collapse was 29%. A bipedicular approach was used for 82% (133/163) levels and unipedicular in 18% (30/163). There was no leakage in 50%, minimal leakage in 42% and moderate leakage noted in 8% of cases. Both unipedicular and bipedicular approaches showed leaks in 50% of cases. The most frequent pattern of leak was venous indicated in 52% of leaks, the adjacent disc in 46% and paravertebral in 5%. The pattern of leakage was always limited to one region except in two cases. There were no symptomatic leaks that required surgical intervention.
Conclusions Vertebroplasty in osteoporotic fractures using a highly viscous cement that can be safely controlled and injected via a hydrolic system can be performed safely without significant complications.
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Competing interests BG—DePuy Spine, Arthrocare Spine, Spine Alien, Ossoen LLC, Dfine.