Surgical procedure and initial radiographic results of a new augmentation technique for vertebral compression fractures

摘要

Purpose: Recently, a new minimally invasive technique called 'vertebral body stenting' (VBS) was introduced for the treatment of osteoporotic vertebral fractures. The technique was developed to prevent the loss of reduction after deflation of the balloon and to reduce the complication rate associated with cement leakage. Methods: The amount of kyphosis correction, improvement of vertebral body height and quantitative cement leakage rate by applying CT-based quantitative volumetry after VBS were measured in 27 patients (55 vertebra) and compared with a control group (29 patients, 61 vertebrae), which was treated with conventional vertebroplasty. Results: After VBS, a significant improvement was seen in vertebral height, compared to conventional vertebroplasty. The mean improvement in segmental kyphosis and vertebral kyphosis were 5.8 (p 0.05) and 3.5 (p 0.05), respectively. In the VBS group, the mean injected volume of cement per vertebral body was 7.33 cm3 (3.34-10.19 cm 3). The average amount of cement outside the vertebrae was 0.28 cm3 (0.01-1.64 cm3), which was 1.36 of the applied total cement volume. In the vertebroplasty group, the applied mean volume of the cement per level was 2.7 cm3 (1-5.8 cm3) and the average amount of cement outside the vertebrae was 0.15 cm3 (0.01-1.8 cm 3), which was 11.5 (0.2-60 ) of the applied total volume of cement. Conclusion: The frequency of cement leakage after VBS was 25.5 compared to 42.1 in the vertebroplasty group. VBS led to a significant decrease in the leakage rate compared with conventional vertebroplasty.