Document Detail


Cement leakage: safety of minimally invasive surgical techniques in the treatment of multiple myeloma vertebral lesions.
MedLine Citation:
PMID:  22411037     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate and address the safety of vertebroplasty (VP) and kyphoplasty (KP) in terms of rate and type of cement leakage in the treatment of Multiple Myeloma (MM) vertebral fractures.
METHODS: A total number of 37 treated vertebrae were evaluated post-operatively by using standard X-rays and CT scan looking for a cement leakage. VP was done using a monoportal approach in all cases (18 treated levels, group A), while KP was done using a monopedicular approach in 9 levels (group B1) and using a bipedicular approach in the remaining 10 levels (group B2). A computed tomography was used to establish the presence of any cement leakage and to determine its localization.
RESULTS: Vertebral augmentation through VP and KP provides immediate pain relief and an improvement of the quality of life of patients affected by MM but it is gravated by high risk of cement leakage. Cement extravasation occurred in 27.7% of total VP procedures and in 21.05% of total KP procedures, but considering the whole number of treated levels, it was more common in multi-level VP and in bipedicular KP, in which a higher quantity of cement was employed.
CONCLUSIONS: KP procedure in these patients is slightly less risky but we suggest doing it with a monopedicular approach. It's mandatory to use an high viscosity cement and we suggest not to use an amount of PMMA over 2 cc and a previous treatment with bone marrow transplant is related to a lower risk of cement leakage.
Authors:
Giovanni Andrea La Maida; Laura Serena Giarratana; Alberto Acerbi; Valentina Ferrari; Giuseppe Vincenzo Mineo; Bernardo Misaggi
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2012-03-13
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  21 Suppl 1     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-24     Completed Date:  2012-11-06     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  S61-8     Citation Subset:  IM    
Affiliation:
Spine Surgery Division, Gaetano Pini Orthopaedic Institute, Piazza Cardinale Andrea Ferrari 1, 20122 Milan, Italy. giovanniandrea.lamaida@gpini.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Bone Cements*
Cohort Studies
Extravasation of Diagnostic and Therapeutic Materials / epidemiology*
Female
Humans
Incidence
Kyphoplasty / adverse effects,  methods*
Lumbar Vertebrae / injuries,  radiography,  surgery
Male
Middle Aged
Multiple Myeloma / complications,  radiography,  surgery*
Retrospective Studies
Spinal Fractures / etiology,  radiography,  surgery
Surgical Procedures, Minimally Invasive / adverse effects,  methods*
Thoracic Vertebrae / injuries,  radiography,  surgery
Tomography, X-Ray Computed
Vertebroplasty / adverse effects,  methods*
Chemical
Reg. No./Substance:
0/Bone Cements
Comments/Corrections

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