Percutaneous vertebroplasty, kyphoplasty and lordoplasty: implications for the anesthesiologist

Luginbühl, Martin (2008). Percutaneous vertebroplasty, kyphoplasty and lordoplasty: implications for the anesthesiologist. Current opinion in anaesthesiology, 21(4), pp. 504-13. Hagerstown, Md.: Lippincott Williams & Wilkins 10.1097/ACO.0b013e328303be62

Text R09_Luginbuehl_VertebroplastyCOAn2008.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (2MB) | Request a copy

PURPOSE OF REVIEW: Vertebroplasty, kyphoplasty and lordoplasty are minimally invasive procedures mainly performed for refractory pain due to osteoporotic vertebral body fractures. This review summarizes recent findings on outcome, complications and their impact on anesthetic management. RECENT FINDINGS: Despite an increasing number of publications on surgical technique, therapeutic efficacy and side effects of these interventions, anesthetic management per se is hardly investigated. All three treatments provide similar pain relief. Adverse effects include local cement leakage and new fractures adjacent to augmented vertebrae. Asymptomatic pulmonary cement embolism occurs in 4.6-6.8% of patients depending on cement viscosity, injection pressure and number of injected vertebrae. Potentially life-threatening embolism of cement or fat may occur. Kyphoplasty and lordoplasty aim at correcting vertebral deformity and are equally effective; lordoplasty is substantially less expensive, however. The incidence of systemic cement or fat embolism is similar to that in vertebroplasty. Whereas vertebroplasty is mostly performed under local anesthesia and sedation, general anesthesia is required for kyphoplasty and lordoplasty. The anesthetic regimen follows the principles of anesthesia in the elderly population. SUMMARY: Vertebroplasty, kyphoplasty and lordoplasty are effective minimally invasive treatments for stable vertebral compression fractures without compression of the spinal canal. The anesthesiologist must be prepared to manage systemic cement or fat embolism.

Interest & Impact

Downloads

1 since deposited on 04 Oct 2013
0 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item