Vertebral Body Lavage Reduces Hemodynamic Response to Vertebral Body Augmentation With PMMA.

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)

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; Schott, Philipp; Ahmad, Sufian; Benneker, Lorin Michael; Nieuwkamp, Nadine and 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:

24 Oct 2019 21:22

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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