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Vertebroplasty with a side opening-cannula effective for compression fractures
Researchers also found balloon kyphoplasty can reduce cement leakage, but at a greater cost.
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CHICAGO — The use of a side-opening cannula can help reduce cement leakage during vertebroplasty for the treatment of vertebral compression fractures, according to researchers in Brazil.
Nicandro Figueiredo, MD, PhD, shared his findings at the Annual Meeting of the North American Spine Society, here.
A prospective analysis
Figueiredo and colleagues performed a prospective analysis of percutaneous vertebroplasties performed between January 2003 and February 2008, as well as a series of balloon kyphoplasties performed from March 2008 to November 2010. All of the procedures were performed on patients with painful vertebral compression fractures. The percutaneous vertebroplasties were performed using either the traditional front-opening cannula or the newer side-opening cannula.
The researchers included 47 percutaneous vertebroplasties performed in a total of 30 patients. The investigators randomly choose 22 percutaneous vertebroplasties to be performed using the side-opening cannula and 25 to be performed using the front-opening cannula. The researchers also prospectively studied 41 kyphoplasties performed in a total of 24 patients. The results of this group were compared to those of the percutaneous vertebroplasty groups.
The investigators used postoperative X-rays and CT scans to determine cement leakage.
Leakage rates
Use of the traditional cannula resulted in cement leaks for 17 (68%) procedures, while the side-opening device resulted in leaks for six (27.3%) procedures. There was no significant difference between the average number of injections between the percutaneous vertebroplasty groups, Figueiredo said.
Cement leakage was significantly reduced with kyphoplasty, he reported, with six instances (14.6%) in the 41 procedures. However, kyphoplasty also added significant cost to treatment.
All patients, Figueiredo noted, experienced an improvement in pain scores as measured through the visual analog scale.
“The pain results were good for all the patients,” he said. “There were no significant differences in 1 month and 6 months of follow-up.”
Considering pain control was similar across all groups, with “good improvement” being reported in most patients with no clinical complications, Figueiredo noted the results indicated safety and efficacy of the side-opening cannula, as well as a low rate of leakage for balloon kyphoplasty.
“The results show a lower rate of cement leakage with the kyphoplasty, a reasonable rate with the new side-opening cannula and a high rate of cement leakage with the traditional front-opening cannula,” Figueiredo concluded. “But, I would like you to remember that there were no clinical complications — the leaks were asymptomatic.”
“We can reduce cement leakage with kyphoplasty, but also we can reduce cement leakage with the side-opening cannula for vertebroplasty,” he added. “Both procedures are considered safe and efficient, and as I said, we had no complications.” – by Robert Press
Reference:
- Figueiredo N Gonsales D, Casulari L. Kyphoplasty versus percutaneous vertebroplasty using the traditional and the new side-opening cannula for the osteoporotic vertebral fracture. Paper #66. Presented at the Annual Meeting of the North American Spine Society. Nov. 2-5, 2011. Chicago.
For more information:
- Nicandro Figueiredo, MD, PhD, can be reached at Av. das Flores, n. 941, 1st floor, INEC, Jardim Cuiabá Cuiabá – MT Brazil 78.043-172; 55 65 3624-3222; email: nicandro2@yahoo.com
- Disclosure: Figueiredo has no relevant financial disclosures.