BMC Musculoskeletal Disorders | |
Initial clinical experience with a novel vertebral augmentation system for treatment of symptomatic vertebral compression fractures: A case series of 26 consecutive patients | |
Jon E Block2  Larry E Miller2  Thomas Repantis1  Panagiotis Korovessis1  | |
[1] Orthopaedic Department, General Hospital "Agios Andreas", 1 Tsertidou str, 26224 Patras, Greece;Jon E. Block, PhD, Inc., 2210 Jackson Street, Suite 401, San Francisco, CA 94115 USA | |
关键词: Vertebral augmentation; Osteoporosis; Minimally invasive; Fracture; | |
Others : 1152272 DOI : 10.1186/1471-2474-12-206 |
|
received in 2011-02-11, accepted in 2011-09-22, 发布年份 2011 | |
【 摘 要 】
Background
Minimally invasive vertebral augmentation procedures are widely used to treat vertebral compression fractures although procedural polymethylmethacrylate cement leakage remains common. We report herein our initial experience with a novel vertebral augmentation technique designed to treat symptomatic vertebral osteoporotic fractures and osteolytic metastases with minimal cement extravasation.
Methods
Forty-two vertebral fractures were identified in 26 consecutive patients (mean age 74 ± 9 years). All patients were treated with a novel percutaneous vertebral augmentation device (Kiva® VCF Treatment System, Benvenue Medical, Santa Clara, CA, USA). Indications for surgery included recent (≤ 3 months) symptomatic osteoporotic vertebral fracture (n = 34) and pathologic vertebral fractures (e.g. metabolic bone disease, myeloma, metastasis) (n = 8) located between T10 and S1. Patient outcomes were evaluated pre-treatment and at 2- and 6-month follow-up visits. Postoperative cement extravasation was assessed with computed tomography. Patient-reported back pain was quantified using an 11-point numeric scale. Back-specific functional disability was self-reported with the Oswestry Disability Index on a 0 to 100% scale.
Results
No cases of intraoperative hypotension, respiratory disturbance, neurological deterioration, infection, or death were observed. There were 2 (4.8%) levels where anterior cement leakage was visible radiographically in patients with osteolyses. No intracanal leakage was observed. Back pain scores improved 71% (p < 0.001) from pre-treatment to the 6-month follow-up. Back function improved 56% from baseline to 6 months (p < 0.001).
Conclusions
The initial clinical experience with the Kiva® System demonstrated significant improvements in back pain and function with minimal and clinically insignificant procedural cement leakage.
【 授权许可】
2011 Korovessis et al; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150406151229531.pdf | 2117KB | download | |
Figure 3. | 62KB | Image | download |
Figure 2. | 253KB | Image | download |
Figure 1. | 215KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
Figure 3.
【 参考文献 】
- [1]Johnell O, Kanis JA: An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 2006, 17(12):1726-1733.
- [2]Cook DJ, Guyatt GH, Adachi JD, Clifton J, Griffith LE, Epstein RS, Juniper EF: Quality of life issues in women with vertebral fractures due to osteoporosis. Arthritis Rheum 1993, 36(6):750-756.
- [3]Leech JA, Dulberg C, Kellie S, Pattee L, Gay J: Relationship of lung function to severity of osteoporosis in women. Am Rev Respir Dis 1990, 141(1):68-71.
- [4]Schlaich C, Minne HW, Bruckner T, Wagner G, Gebest HJ, Grunze M, Ziegler R, Leidig-Bruckner G: Reduced pulmonary function in patients with spinal osteoporotic fractures. Osteoporos Int 1998, 8(3):261-267.
- [5]Silverman SL: The clinical consequences of vertebral compression fracture. Bone 1992, 13(Suppl 2):S27-31.
- [6]Gold DT: The clinical impact of vertebral fractures: quality of life in women with osteoporosis. Bone 1996, 18(3 Suppl):185S-189S.
- [7]Gold DT: The nonskeletal consequences of osteoporotic fractures. Psychologic and social outcomes. Rheum Dis Clin North Am 2001, 27(1):255-262.
- [8]Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, Licata A, Benhamou L, Geusens P, Flowers K, et al.: Risk of new vertebral fracture in the year following a fracture. JAMA 2001, 285(3):320-323.
- [9]Lyritis GP, Mayasis B, Tsakalakos N, Lambropoulos A, Gazi S, Karachalios T, Tsekoura M, Yiatzides A: The natural history of the osteoporotic vertebral fracture. Clin Rheumatol 1989, 8(Suppl 2):66-69.
- [10]Bouza C, Lopez T, Magro A, Navalpotro L, Amate JM: Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review. Eur Spine J 2006, 15(7):1050-1067.
- [11]Gangi A, Guth S, Imbert JP, Marin H, Dietemann JL: Percutaneous vertebroplasty: indications, technique, and results. Radiographics 2003, 23(2):e10.
- [12]Hadjipavlou AG, Tzermiadianos MN, Katonis PG, Szpalski M: Percutaneous vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures and osteolytic tumours. J Bone Joint Surg Br 2005, 87(12):1595-1604.
- [13]Ledlie JT, Renfro MB: Kyphoplasty treatment of vertebral fractures: 2-year outcomes show sustained benefits. Spine (Phila Pa 1976) 2006, 31(1):57-64.
- [14]Lieberman IH, Dudeney S, Reinhardt MK, Bell G: Initial outcome and efficacy of "kyphoplasty" in the treatment of painful osteoporotic vertebral compression fractures. Spine (Phila Pa 1976) 2001, 26(14):1631-1638.
- [15]Majd ME, Farley S, Holt RT: Preliminary outcomes and efficacy of the first 360 consecutive kyphoplasties for the treatment of painful osteoporotic vertebral compression fractures. Spine J 2005, 5(3):244-255.
- [16]Rao RD, Singrakhia MD: Painful osteoporotic vertebral fracture. Pathogenesis, evaluation, and roles of vertebroplasty and kyphoplasty in its management. J Bone Joint Surg Am 2003, 85-A(10):2010-2022.
- [17]Klazen CA, Lohle PN, de Vries J, Jansen FH, Tielbeek AV, Blonk MC, Venmans A, van Rooij WJ, Schoemaker MC, Juttmann JR, et al.: Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet 2010, 376(9746):1085-1092.
- [18]Wardlaw D, Cummings SR, Van Meirhaeghe J, Bastian L, Tillman JB, Ranstam J, Eastell R, Shabe P, Talmadge K, Boonen S: Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet 2009, 373(9668):1016-1024.
- [19]Taylor RS, Fritzell P, Taylor RJ: Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis. Eur Spine J 2007, 16(8):1085-1100.
- [20]Eck JC, Nachtigall D, Humphreys SC, Hodges SD: Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature. Spine J 2008, 8(3):488-497.
- [21]Fairbank JC, Pynsent PB: The Oswestry Disability Index. Spine (Phila Pa 1976) 2000, 25(22):2940-2952; discussion 2952.
- [22]Gill JB, Kuper M, Chin PC, Zhang Y, Schutt R Jr: Comparing pain reduction following kyphoplasty and vertebroplasty for osteoporotic vertebral compression fractures. Pain Physician 2007, 10(4):583-590.
- [23]Buchbinder R, Osborne RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, Graves S, Staples MP, Murphy B: A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 2009, 361(6):557-568.
- [24]Kallmes DF, Comstock BA, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH, Edwards R, Gray LA, Stout L, Owen S, et al.: A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 2009, 361(6):569-579.
- [25]Rousing R, Hansen KL, Andersen MO, Jespersen SM, Thomsen K, Lauritsen JM: Twelve-months follow-up in forty-nine patients with acute/semiacute osteoporotic vertebral fractures treated conservatively or with percutaneous vertebroplasty: a clinical randomized study. Spine (Phila Pa 1976) 2010, 35(5):478-482.
- [26]Mirovsky Y, Anekstein Y, Shalmon E, Blankstein A, Peer A: Intradiscal cement leak following percutaneous vertebroplasty. Spine (Phila Pa 1976) 2006, 31(10):1120-1124.