ABSTRACT

Cement leakage is a common problem during percutaneous vertebroplasty and can lead to complications such as pulmonary embolism, nerve root and cord compression.

To evaluate of the effectiveness of vertebrography (contrast injection) before the cement application in the vertebroplasty procedure.

Thirty percutaneous vertebroplasty procedures had been done between 2005 and 2007 in our department. Of these four cases were metastatic or primary tumors of vertebral column. Rest of the patients was suffered from osteoporotic vertebral fractures. Eighteen were female and nine were male. The average age was 72. Mean follow-up was 19 months.

Non-ionic contrast media injection was performed as an integral part of procedure to the all of the patient. 2 ml of contrast media was injected after the placement of Jam-Sheedy needle transpedicularly to the vertebral body.

VAS and Oswestry scores were used for the clinical evaluation. For the radiological assessment the sagittal index, local kyphosis angle and compression rate were measured for all the patients. VAS and Oswestry scores were improved in most of the patients significantly (p<0.05). There were no significant difference between the preoperative and postoperative radiographic measurements (p>0.05). Three patients had contrast leakage to the epidural space. In these patients, cement was injected only from the contralateral side or the place of the needle tip was changed.

Vertebrography seems to be an effective and safe trick of trade for the prevention of the cement leakage in percutaneous vertebroplasty.