Vertebral Body Augmentation with Osteoconductive Bone Cement - Initial Experience.


Viktors Vestermanis Janis Ositis
Neurosurgical Clinic, Pauls Stradins Clinical University Hospital, Riga, Latvia

Introduction: Vertebroplasty with polymethylmethacrylate (PMMA) is a widely used surgical procedure. Despite the high pain relief rate, negative effects of the PMMA are reported, so as depression of the osteogenesis, local hyperthermia, which can cause severe cardiovascular disturbances. The use of bio-ceramic osteoconductive bone cements (OCBC) avoid those risks.

Aim of the study: Evaluation of the effectiveness of the use of osteoconductive bone cement CERAMENT SPINE SUPPORT (CSS) for Vertebroplasty in patients with vertebral fractures type A.1.1 and A.1.2.

Materials & methods: CSS is a composite substance, containing calcium sulphate, hydroxyapatite and iodine based water-soluble contrast medium.

Vertebroplasty was performed in 10 females (average age 48.53 years) and 7 males (average age 32.8 years) with A.1.1 and A.1.2 fractures.

In 14 patients Vertebroplasty was performed in one level, in 2 patients – in two levels. 1 patient underwent balloon Kyphoplasty and 1 patient – simultaneously with CT guided Sacroplasty.

Patients with osteoporotic vertebral fractures (OVF) (4 patients, average age 74 years) were admitted to the hospital with severe back pain, VAS 6.1.

Patients with traumatic vertebral fractures (TVF) (13 patients, average age 31.33 years) were admitted in 1-3 days after the accident. VAS 8.7.

The average volume of CSS was 6.9 ml.

Results: The VAS score in 24-48 hours after the Vertebroplasty with CSS in the OSL group was 2.3, but in the TVF – 1.9. The higher VAS rate in the OVF group can be associated with persisting degeneration of the spine.

Material related complications or side effects was not recognized.

Conclusions:

Vertebroplasty with OCBC CSS provides good pain relief in patients with A.1.1 and A1.2 vertebral fractures.

OCBC CSS demonstrates high rate of osteointegration and provides physiologic bone restoration in the fracture area.

The hardening of the OCBC CSS is normothermic. It avoids the risk of cardiovascular disturbances.