Vertebral Augmentation
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Vertebral Augmentation
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Author : Douglas P. Beall
language : en
Publisher: Thieme
Release Date : 2020-02-28
Vertebral Augmentation written by Douglas P. Beall and has been published by Thieme this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-02-28 with Medical categories.
The definitive guide to performing vertebroplasty, kyphoplasty, and implant augmentation from national and international experts Vertebral compression fractures (VCFs) result from trauma or pathologic weakening of the bone and are associated with conditions such as osteoporosis or malignancy. Worldwide, VCFs impact one in three women and one in eight men aged 50 and older, with more than 8.9 million fractures incurred annually. Copublished by Thieme and the Society of Interventional Radiology, Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation provides a practical, clinical discussion of these minimally invasive spine interventions. Written and edited by Douglas Beall along with associate editors Allan Brook, M. R. Chambers, Joshua Hirsch, Alexios Kelekis, Yong-Chul Kim, Scott Kreiner, and Kieran Murphy, this richly illustrated book presents a multidisciplinary and international perspective. It features contributions from renowned experts in interventional radiology, neurosurgery, pain medicine, and physiatry. This resource fills a gap in the literature, with extensive updates on a vast amount of new information and techniques that have been introduced during the past decade. Thirty-five chapters address treatment of spine fractures, starting with a history and introduction to vertebral augmentation, discussion of VCFs, patient assessments, physical exam findings, pain management, and much more. Key Features Procedural chapters cover vertebroplasty, sacroplasty, cervical and posterior arch augmentation, balloon kyphoplasty, and vertebral augmentation with implants and for challenging pathologies Special topics include radiation exposure and protection, post-procedure physical therapy, osteoporosis treatment, postural fatigue syndrome, the effect on morbidity and mortality, and cementoplasty outside the spine Treatment of complex cases are also discussed extensively, including chronic vertebral compression fractures, neoplastic vertebral compression fractures, instrumented spinal fusions, and severe benign and malignant fractures The final chapter features 16 subchapters from global masters of vertebral augmentation, with personal tips, tricks, and pearls they use in their own practices This is a must-have resource for interventional radiology, neurosurgery, interventional pain management, and orthopaedic surgery residents and fellows, as well as seasoned clinicians who wish to incorporate these procedures into practice.
Vertebral Augmentation
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Author : Douglas P. Beall
language : en
Publisher: Thieme
Release Date : 2020-02-28
Vertebral Augmentation written by Douglas P. Beall and has been published by Thieme this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-02-28 with Medical categories.
The definitive guide to performing vertebroplasty, kyphoplasty, and implant augmentation from national and international experts Vertebral compression fractures (VCFs) result from trauma or pathologic weakening of the bone and are associated with conditions such as osteoporosis or malignancy. Worldwide, VCFs impact one in three women and one in eight men aged 50 and older, with more than 8.9 million fractures incurred annually. Copublished by Thieme and the Society of Interventional Radiology, Vertebral Augmentation: The Comprehensive Guide to Vertebroplasty, Kyphoplasty, and Implant Augmentation provides a practical, clinical discussion of these minimally invasive spine interventions. Written and edited by Douglas Beall along with associate editors Allan Brook, M. R. Chambers, Joshua Hirsch, Alexios Kelekis, Yong-Chul Kim, Scott Kreiner, and Kieran Murphy, this richly illustrated book presents a multidisciplinary and international perspective. It features contributions from renowned experts in interventional radiology, neurosurgery, pain medicine, and physiatry. This resource fills a gap in the literature, with extensive updates on a vast amount of new information and techniques that have been introduced during the past decade. Thirty-five chapters address treatment of spine fractures, starting with a history and introduction to vertebral augmentation, discussion of VCFs, patient assessments, physical exam findings, pain management, and much more. Key Features Procedural chapters cover vertebroplasty, sacroplasty, cervical and posterior arch augmentation, balloon kyphoplasty, and vertebral augmentation with implants and for challenging pathologies Special topics include radiation exposure and protection, post-procedure physical therapy, osteoporosis treatment, postural fatigue syndrome, the effect on morbidity and mortality, and cementoplasty outside the spine Treatment of complex cases are also discussed extensively, including chronic vertebral compression fractures, neoplastic vertebral compression fractures, instrumented spinal fusions, and severe benign and malignant fractures The final chapter features 16 subchapters from global masters of vertebral augmentation, with personal tips, tricks, and pearls they use in their own practices This is a must-have resource for interventional radiology, neurosurgery, interventional pain management, and orthopaedic surgery residents and fellows, as well as seasoned clinicians who wish to incorporate these procedures into practice.
Vertebral Augmentation Techniques
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Author : Alaa Abd-Elsayed
language : en
Publisher: Elsevier Health Sciences
Release Date : 2023-02-14
Vertebral Augmentation Techniques written by Alaa Abd-Elsayed and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2023-02-14 with Medical categories.
Vertebral Augmentation Techniques, part of the Atlas of Interventional Pain Management series, is a concise, practical guide that provides clinicians with detailed, step-by-step guidance on how to perform the latest interventional techniques for treating patients with chronic pain as a result of vertebral fractures or osteoporosis. This comprehensive, easy-to-follow guide offers expert coverage of how to deliver safe, accurate, and cost-effective pain relief to patients using all clinically useful imaging modalities, including ultrasound-guided techniques and fluoroscopy. With high-quality images and clear, authoritative guidance throughout, it shows exactly how to evaluate the causes of pain, identify the most promising stimulation technique, locate the site with precision, and deliver effective relief. Offers a comprehensive overview of the latest techniques used in vertebral augmentation. Features clinically relevant anatomic drawings and radiologic images that provide step-by-step instruction on techniques. Provides clear guidance on the risks and benefits, as well as indications and contraindications, for each procedure. Covers key topics such as Vertebroplasty/Kyphoplasty: Transpedicular Approach; Balloon Augmentation; Vertebral Augmentation with Osteotome; Vertebral Augmentation Using Expandable Intravertebral Implants; Basivertebral Nerve Ablation; and more. Includes easy-to-follow, templated content on patient selection, preoperative prep, and post-operative care. Contains full-color line drawings, photographs, and ultrasound images that provide you with a firm grasp of the anatomy and equipment involved with each procedure. Highlights potential pitfalls for each technique and offers clinical pearls on how to avoid them.
Vertebral Augmentation
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Author : Douglas P. Beall
language : en
Publisher:
Release Date : 2020
Vertebral Augmentation written by Douglas P. Beall and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020 with categories.
Vertebral Augmentation Involving Vertebroplasty Or Kyphoplasty For Cancer Related Vertebral Compression Fractures
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Author :
language : en
Publisher:
Release Date : 2016
Vertebral Augmentation Involving Vertebroplasty Or Kyphoplasty For Cancer Related Vertebral Compression Fractures written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016 with categories.
The objectives of this review were to evaluate the effectiveness and safety of percutaneous image-guided vertebral augmentation techniques, vertebroplasty and kyphoplasty, for palliation of cancer-related vertebral compression fractures. [...] Owing to the heterogeneity of the clinical reports, we performed a narrative synthesis based on an analytical framework constructed for the type of cancer- related vertebral fractures and the diversity of the vertebral augmentation interventions. [...] Objectives of Analysis The objectives of this analysis were to evaluate the effectiveness and safety of two percutaneous image-guided vertebral augmentation interventions-vertebroplasty or kyphoplasty-for cancer-related vertebral compression fractures and to evaluate their comparative effectiveness with conservative management. [...] Clinical Need and Target Population In spinal metastatic disease, vertebral compression fractures commonly occur in the lumbar and thoracic regions of the spine and have been classically defined as a loss of vertebral body height of at least 20%.17 Fractures can also occur in high-risk cervical areas and sacral regions of the spine, and patients can have complex multilevel fracture patterns involv [...] Both of these procedures aim to primarily manage pain and involve the injection of bone cement (polymethylmethacrylate [PMMA]) into the vertebral body.28 Kyphoplasty also aims to restore the height of the collapsed vertebrae and to correct spinal kyphosis, if present.29 Kyphoplasty involves the use of an inflatable balloon catheter to create a cavity in which bone cement can be injected, and to at.
Risk Of Subsequent Adjacent Fractures After Vertebral Augmentation In The Treatment For Osteoporotic Vertebral Compression Fractures
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Author : José Manuel Ortega Zufiría
language : en
Publisher: GRIN Verlag
Release Date : 2020-11-04
Risk Of Subsequent Adjacent Fractures After Vertebral Augmentation In The Treatment For Osteoporotic Vertebral Compression Fractures written by José Manuel Ortega Zufiría and has been published by GRIN Verlag this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-11-04 with Medical categories.
Research Paper (postgraduate) from the year 2020 in the subject Medicine - Other, grade: 10.00, , course: NEUROCIRUGÍA, language: English, abstract: The aim of this study was to investigate whether percutaneous vertebral augmentation (PVA) was associated with clinical and radiological subsequent adjacent fractures. A systematic review and meta-analysis was performed searching on PubMed, EMBASE, Cochrane library, Google Scholar, web of science and ClinicalTrial.gov from the establishment of the database to January 2020. Eligible studies assessing the subsequent adjacent fractures after PVA compared with conservative treatment (CT) were incorporated. The pooled risk ratio (RR) with its 95% confidence intervals (95% CI) was used. Heterogeneity, sensitivity and publication bias analyses were performed. A total of 24 studies were considered eligible and were included finally. 20/421 patients (4.75%) had clinical subsequent adjacent fractures from PVA group, and 25/359 patients (6.96%) had from CT group, and 46/440 patients (10.45%) from PVA group and 36/444 patients (8.10%) from CT group had radiological subsequent adjacent fractures. There both had no significant difference between two groups (RR=0.67, 95%CI: [0.38, 1.19], P = 0.17)/ (RR=1.13, 95%CI: [0.75, 1.70], P = 0.576). However, in fractured vertebrae, number in PVA group was more than that in CT group (RR=1.41, 95%CI: [1.03, 1.93], P = 0.03). Collectively, currently available literature provides data showed PVA did not increase the incidence for subsequent adjacent fractures, no matter it was clinical or radiological fracture. But PVA may increase the number of fractured vertebrae.
Vertebral Body Augmentation Vertebroplasty And Kyphoplasty In Spine Surgery
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Author : Stefano Telera
language : en
Publisher: Springer Nature
Release Date : 2021-06-23
Vertebral Body Augmentation Vertebroplasty And Kyphoplasty In Spine Surgery written by Stefano Telera and has been published by Springer Nature this book supported file pdf, txt, epub, kindle and other format this book has been release on 2021-06-23 with Medical categories.
This book offers an updated and comprehensive review of the role of vertebroplasty, kyphoplasty and augmentation techniques in all fields of orthopedic surgery, neurosurgery, and interventional radiology. Addressing the latest advances in terms of the materials used and combined approaches with other mini-invasive techniques, it reveals how vertebroplasty, kyphoplasty and various augmentation techniques could become instrumental to helping patients with specific vertebral compression fractures or other diseases of the vertebral column. The book includes a detailed history of the techniques’ development, descriptions of the materials used in the last twenty years, and extensive information on the biomechanical basis, anatomy and current indications for vertebroplasty, kyphoplasty and augmentation. In addition, it highlights representative cases to enhance readers’ understanding of each topic, and particular attention is paid to the innovative evolution of the techniques and to their combination with other mini-invasive approaches, stents and brachytherapy. Given its scope, the book offers a valuable guide for all neurosurgeons, orthopedic surgeons, and interventional radiologists whose work involves spine pathologies and their treatment.
Biomechanical Evaluation Of Vertebral Augmentation To Compare Biocure Cement With Pmma
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Author : Devdatt D. Mhatre
language : en
Publisher:
Release Date : 2011
Biomechanical Evaluation Of Vertebral Augmentation To Compare Biocure Cement With Pmma written by Devdatt D. Mhatre and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011 with Biomechanics categories.
A vertebral compression fracture occurs when the vertebral body of the spine is collapsed due to trauma. In certain circumstances and population groups such as elderly people or in individuals with osteoporotic disorder and cancer, vertebral compression fracture may occur with a minimal compressive force. The most common location of such fractures is in the anterior column of the thoracolumbar region of the spine forming an anterior wedge fracture. Vertebral augmentation is a minimally invasive surgical procedure of cement injection in a collapsed vertebra used to stabilize and reinforce such compression fracture and has proven to be effective in relieving pain compared to conservative treatments. This study was focused on the adjacent level fractures caused due to possible mismatch between augmented osteoporotic bone and high modulus cement resulting in inappropriate load sharing. Biocompliant Biocure bone cement with modulus matching trabecular bone was evaluated and compared with commercially available high modulus PMMA cement. A three dimensional, non-linear osteoporotic T12-L3 finite element model was developed and validated for this study. The finite element mesh of the L1 vertebral body was modified to form oval concentric cylinders in order to simulate a vertebral augmentation in the center of the vertebral body. A compression fracture was simulated in the L1 vertebral body by using a modulus reduction criterion. Vertebral augmentation was then simulated at two distinct cement stiffness values of Biocure and PMMA bone cement to compare with osteoporotic model. The load control protocol was used to evaluate motion of the spine and parameters like Von Mises stresses, intradiscal pressure, facet loads, and stress contour plots were analyzed for each model. The load transferred through the facets decreased and the corresponding endplate stresses increased with increase in cement stiffness. The study also indicated that when a particular level was treated, a higher effect on the stresses was observed at an adjacent upper level than an adjacent lower level. Trends were most evident in the compression loading configuration and at the largest cement volume. Cadaveric kinematic experiments were carried out to investigate the motion in the spinal segment as well as to analyze the increase in intradiscal pressure at adjacent levels when loaded and augmented with Biocure and PMMA cement. Fatigue performance was studied by mechanically loading the augmented vertebral segment (with Biocure and PMMA) for 1.25 million cycles. This was followed by computer tomography scan evaluation for potential endplate cracks. Additionally, destructive sectioning of augmented vertebrae was undertaken for possible cement cracks due to fatigue loading. The results of this study provide an insight on the mechanics of vertebral augmentation with respect to variation in cement properties. Load sharing with Biocure bone cement augmentation was similar to intact compared to PMMA. Fatigue analysis helped in evaluating the long term sustainability of Biocure cement when augmented in the osteoporotic bone. This suggests that cement stiffness lower than the commercially available (high modulus) bone cement may be beneficial from biomechanical perspective.
Third Generation Percutaneous Vertebral Augmentation Procedures
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Author : Vincenzo Salini
language : en
Publisher: Nova Science Publishers
Release Date : 2015
Third Generation Percutaneous Vertebral Augmentation Procedures written by Vincenzo Salini and has been published by Nova Science Publishers this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015 with Endoscopic surgery categories.
Vertebroplasty and kyphoplasty represented and represent two mainstays of minimally invasive spine surgery. Inevitably, these procedures left some unresolved issues that must be solved. This monograph is born from a concrete and shared necessity: to clarify indications and limits, to assess advantages and disadvantages and to identify new perspectives relating to use of third generation devices for percutaneous vertebral augmentation. Actually, the concept of minimally invasive surgery and tissue sparing surgery are revolutionizing always the surgical approach to many diseases, especially for spine surgery: therefore it is important to know the "when and how". This text does not want to be anything more than a "short essay", and it is aimed especially to young people, residents and specialists, but also to all those who are desirous to find and to read "something" that can be a basis for reflection, even in order to improve their surgical technique. In line with United States and Northern Europe, we are sure that the differences between Orthopaedic Surgeon and Neurosurgeon should be complementary, in order to prompt a curious comparison for creating partnerships and not barriers. In fact, this monograph is the result of the work among Neurosurgeons and Orthopaedic Surgeons. This work is born from the collaboration of many surgeons: the "elder" ones, who have offered all their knowledge and experience and the "young" ones, who are eager to learn, know and especially to share between them. In this text, spine functional anatomy and biomechanics brief mentions will be done, in order to understand well the etiology and the evolution of spinal pathology, both traumatic, metabolic and tumoral; the different treatment options will be taken into account, the open and minimally invasive techniques, the percutaneous approaches as well as third generation devices for percutaneous vertebral augmentation. The goal is not to compare the different devices in order to identify a winner. The real goal is to understand what pathological condition can bring out the best properties of a specific device, in order to establish which device is the most appropriate in a specific case. Therefore, through the experiences of Orthopaedic Surgeons, Neurosurgeons and Neuroradiologists, we will explore and identify the correct procedures, but especially the potential "red flags", in this field of research.
Rates And Outcomes Of Vertebral Augmentation For The Treatment Of Osteoporotic Vertebral Fractures Among The Commercially Insured
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Author : Michael Kevin O'Reilly
language : en
Publisher:
Release Date : 2021
Rates And Outcomes Of Vertebral Augmentation For The Treatment Of Osteoporotic Vertebral Fractures Among The Commercially Insured written by Michael Kevin O'Reilly and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2021 with categories.
Approximately 750,000 people per year in the U.S. sustain osteoporotic vertebral fractures (OVF). Vertebroplasty and kyphoplasty, collectively termed vertebral augmentation are commonly used to treat OVF yet the strength of evidence supporting the use of vertebroplasty is weak. Kyphoplasty lacks a robust evidence base to support or reject its use. Prior studies of vertebral augmentation have focused primarily on patients >65 years old. Our aims were twofold; to determine the temporal changes in vertebral augmentation rates over the past decade in a commercially insured, working-age (under 65) American population, and to compare the rates of major medical complications, resource utilization and medication use among a cohort of patients with OVF treated with vertebral augmentation as compared to propensity matched patients not treated with vertebral augmentation. Analysis of patients with OVF in the IBM MarketScan® Commercial Claims and Encounters Databases of Americans with employer-provided health insurance for the 2008-2017 period. To determine changes in OVF and vertebral augmentation rates over time we used ICD-CM 9/10 codes among a total of 149 million individual patients with an age range of 18-65 while excluding those with alternative fracture etiologies such as cancer, infection or transport accidents. We also 1:1 matched augmented patients to controls using propensity scores based on age, gender, region, fracture year, comorbidities, hospital admission at index fracture, and prior pain medication use, with further exact matching on use of opioids and advanced imaging in the time period until augmentation. We assessed rates of major medical complications, opioid use and all cause gross covered payments after augmentation and the analogous number of days from OVF in the control group (baseline day). Conditional logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (95% CI) for categorical variables, with median regression used for the continuous variables. Results: We identified 19,944 patients with OVF with an average incidence of 5.44 OVF per 100,000 MarketScan enrollees per year from 2008 - 2017. A total of 3424 patients (17.2%) with OVF underwent vertebral augmentation. Specifically, 708 (3.5%) were treated with vertebroplasty, 2571 (12.9%) received kyphoplasty and 145 (0.7%) had both. There was a trend of decreased utilisation of vertebroplasty, with a concomitant increase in kyphoplasty procedures performed over the time period. The percentage of patients with OVF treated with vertebral augmentation remained relatively stable. In our outcome analysis, which required 1 year post fracture enrollment we identified 14,995 patients with OVF of whom 2363 (16%) were augmented and 2304 (98%) were matched 1:1 to non-augmented controls, giving a total matched analysis subset of 4608 patients. We combined vertebroplasty and kyphoplasty subjects into a single augmented group for our primary analysis. Approximately 75% of the matched subset were female with a median age of 58 in each group. We did not observe meaningful differences in the odds of major medical complications within 30 days (adjusted OR= 0.89; 95%CI= 0.55, 1.43) comparing augmented to non-augmented patients, or all cause median costs between groups from 3 days post baseline to 1 year post OVF (adjusted difference between medians = $1285; 95%CI= -312, 2703). However, augmented patients were more likely to have filled opioid medications in the 7 to 30 days after the procedure with 33.9% filling a prescription compared to 28.4% among non-augmented subjects (adjusted OR= 1.40; 95%CI= 1.19, 1.64). We noted significant differences in the rates of major spine surgeries, with the augmented group much less likely to receive surgery than the non-augmented control group in the year after OVF with annual rates of 4.86% vs 8.55% (adjusted OR= 0.43; 95%CI= 0.31, 0.60). In our analysis of a large administrative claims database cohort of those under the age of 65 from 2008-2017 we found that 17% of patients with OVF were observed to have undergone vertebral augmentation. The ratio of those treated with kyphoplasty increased overtime and represented 87% of all augmentations performed in 2017. Contrary to previously published findings (in older adults), this analysis found that patients less than 65 years old who underwent vertebral augmentation did not have decreased major medical complications, opioid fills, or all cause payments in the year following their OVF. We found that all cause costs (with cost of augmentation excluded) to be similar in the year following OVF. Augmented patients were significantly less likely to undergo major spine surgery in the year following OVF, suggesting augmentation may diminish the ultimate need for surgery in this younger patient cohort. Clinical Relevance Statement: Vertebral augmentation used to treat osteoporotic fractures in those
