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Cementing the Spine

Posted on: 10/12/2003
Vertebroplasty involves injecting cement into a damaged vertebra. The cement fills the holes and cracks in the bone. This makes the bone stronger. This treatment can be used in vertebrae that have been weakened by osteoporosis and cancer. It can relieve pain almost right away.

One of the problems with this method is that extra cement can leak out. Doctors must estimate how much cement they will need. It is almost impossible to be exact. And the extra cement could cause problems if it gets in the wrong places. This study looked at how much cement leaks out. The authors wanted to find out if extra cement was related to pain or problems in the first week.

Results showed that cement leaked in about 88 percent of patients. It leaked differently depending on the patient's disease. When vertebroplasty was done for osteoporosis, the extra cement tended to leak into the disc. In patients with cancer, the extra cement leaked into many different areas.

All patients had less pain after vertebroplasty. Leakage didn't seem to have much effect on pain results. However, osteoporosis patients with the most leakage seemed to get slightly less pain relief.

This study suggests that cement leakage may not be a major issue in this procedure. Still, extra cement could cause problems. And these authors only looked at results over one week. This means that long-term effects are unknown. The authors recommend that doctors inject the least amount of cement possible. Perfecting the cement injection could make vertebroplasty an even more successful procedure for relieving pain.

References:
Payam Mousavi, et al. Volumetric Quantification of Cement Leakage Following Percutaneous Vertebroplasty in Metastatic and Osteoporotic Vertebrae. In Journal of Neurosurgery: Spine. July 2003. Vol. 99. No. 1. Pp. 56-59.

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