Albers, Christoph E.; Schott, Philipp M.; Ahmad, Sufian S.; Benneker, Lorin M.; Nieuwkamp, Nadine; Hoppe, Sven (2019). Vertebral Body Lavage Reduces Hemodynamic Response to Vertebral Body Augmentation With PMMA. Global spine journal, 9(5), pp. 499-504. Sage 10.1177/2192568218803106
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Study Design
Retrospective comparative study.
Objectives
To assess the effect of vertebral body lavage (VBL) on (1) systemic blood pressure, (2) heart rate, and (3) oxygen saturation following cement augmentation procedures for acute vertebral compression fractures (VCFs).
Methods
A total of 145 consecutive patients undergoing cement augmentation for acute VCF (mean age 74 ± 12 years, age range 42-96 years; 70% female; 475 levels treated) were allocated to the "lavage group" (n = 61 patients; VBL prior to cement application) and to the "control group" (n = 84 patients, no VBL). Mean arterial blood pressure (MAP), heart rate, and oxygen saturation were monitored immediately prior and 3 minutes after cement injection. Logistic regression analysis was performed with ΔMAP ≥10 mm Hg before and after cement injection as the dependent outcome variable and demographic, radiographic, and procedural factors as independent variables.
Results
MAP decreased by mean 3 ± 7.3 mm Hg before and after cement injection in the "lavage group" and 9 ± 10.5 mmHg in the control group (P < .001). There were no significant differences in terms of heart rate and oxygen saturation before and after cement application within each group, or between the 2 groups. Multivariate logistic regression analyses revealed VBL as an independent factor influencing MAP (adjusted odds ratio: 3.49 [confidence interval, 1.16-10.50], P = .03).
Conclusion
VBL prior to cement augmentation procedures reduces the hemodynamic response, most likely resulting from decreased amounts of bone marrow substance displaced into the circulation thereby decreasing the risk of pulmonary fat embolism syndrome.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery 04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy |
UniBE Contributor: |
Albers, Christoph E., Schott, Philipp, Ahmad, Sufian, Benneker, Lorin Michael, Nieuwkamp, Nadine, Hoppe, Sven |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2192-5682 |
Publisher: |
Sage |
Language: |
English |
Submitter: |
Kathrin Aeschlimann |
Date Deposited: |
03 Oct 2019 14:59 |
Last Modified: |
05 Dec 2022 15:31 |
Publisher DOI: |
10.1177/2192568218803106 |
PubMed ID: |
31431872 |
Uncontrolled Keywords: |
fat embolism syndrome kyphoplasty osteoporotic vertebral compression fracture vertebral body lavage vertebroplasty |
BORIS DOI: |
10.7892/boris.133675 |
URI: |
https://boris.unibe.ch/id/eprint/133675 |
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