Abstract
Introduction
The most common complication of osteoporotic is vertebral compression in aged people. Pain and disability pose major problems in these patients. To restore the vertebral height for driving physical stiffness, and loading bearing toward normal limited, kyphoplasty and vertebroplasty with variable filling materials (PMMA, CPC, etc.) have been used for the treatment. For decreasing the rate of PMMA leakage, we performed kyphoplasty with eggshell technique in different characteristics of vertebral wall.
Materials and Methods
Twenty symptomatic vertebral fractures were enrolled. Visual analogue scale (VAS), the oswestry disability index (ODI), and vertebral wall injury score were assessed. The vertebral height loss and changes of kyphotic angle were also recorded by plain X-ray. Three-dimensional CT will be arranged for evaluating the condition of deficiency vertebral wall and central body collapse if needed. After creating cavity by percutaneous bipedicular balloon device, PMMA was injected into weak wall site according the preoperative evaluation or intraoperative finding. The balloon was once again introduced into the created cavity and inflated to achieve the PMMA shield (eggshell method). Outcome, PMMA leakage condition, X-ray, and CT were reviewed postoperatively.
Results
Symptomatic cement extravasation-related complications or leakage on X-ray were not observed in follow-up. Only one adjacent compression fracture has happened in 1 month. Improvement in vertebral height and the mean kyphotic angle was also noted. The mean VAS and ODI decreased significantly from preoperation to postoperation (p < 0.05). The vertebral wall injury score reviews also told us that the eggshell technique is fit for multiple conditions of wall injury.
Conclusion
It is always concerned for the leakage of PMMA during spine surgery. There are many options of new implant for decreasing the rate of leakage. Greene introduces the eggshell technique since 2007. According to our experiences of kyphoplasty with this eggshell technique, the technique is a safe and significantly functional works for decreasing the leakage of PMMA and pain scale in various wall injury conditions.
None declared
Greene DL, Isaac R, Neuwirth M, Bitan FD. The eggshell technique for prevention of cement leakage during kyphoplasty. J Spinal Disord Tech 2007;20(3):229–232