Lavage prior to vertebral augmentation reduces the risk for cement leakage

Hoppe, Sven; Elfiky, Tarek; Keel, Marius Johann Baptist; Aghayev, Emin; Ecker, Timo Michael; Benneker, Lorin Michael (2016). Lavage prior to vertebral augmentation reduces the risk for cement leakage. European spine journal, 25(11), pp. 3463-3469. Springer 10.1007/s00586-015-4191-8

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PURPOSE This study aimed at assessing the cement leakage rate and the filling pattern in patients treated with vertebroplasty, kyphoplasty and stentoplasty with and without a newly developed lavage technique. STUDY DESIGN Retrospective clinical case-control study. METHODS A newly developed bipedicular lavage technique prior to cement application was applied in 64 patients (45.1 %) with 116 vertebrae, ("lavage" group). A conventional bipedicular cement injection technique was used in 78 patients (54.9 %) with 99 levels ("controls"). The outcome measures were filling patterns and leakage rates. RESULTS The overall leakage rate (venous, cortical defect, intradiscal) was 37.9 % in the lavage and 83.8 % in the control group (p < 0.001). Venous leakage (lavage 12.9 % vs. controls 31.3 %; p = 0.001) and cortical defect leakage (lavage 17.2 % vs. controls 63.3 %; p < 0.001) were significantly lower in the lavage group compared to "controls," whereas intradiscal leakages were similar in both groups (lavage 12.1 % vs. controls 15.2 %; p = 0.51). For venous leakage multivariate logistic regression analysis showed lavage to be the only independent predictor. Lavage was associated with 0.33-times (95 % CI 0.16-0.65; p = 0.001) lower likelihood for leakage in compared to controls. CONCLUSIONS Vertebral body lavage prior to cement augmentation is a safe technique to reduce cement leakage in a clinical setting and has the potential to prevent pulmonary fat embolism. Moreover, a better filling pattern can be achieved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Hoppe, Sven; Keel, Marius; Aghayev, Emin; Ecker, Timo and Benneker, Lorin Michael

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0940-6719

Publisher:

Springer

Language:

English

Submitter:

Fabian Röthlisberger

Date Deposited:

22 Mar 2016 08:37

Last Modified:

27 Sep 2017 07:38

Publisher DOI:

10.1007/s00586-015-4191-8

PubMed ID:

26275998

BORIS DOI:

10.7892/boris.75689

URI:

https://boris.unibe.ch/id/eprint/75689

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