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International Orthopaedics
Published in: International Orthopaedics 4/2015

01-04-2015 | Original Paper

Minimum cement volume for vertebroplasty

Authors: David Martinčič, Miha Brojan, Franc Kosel, Darko Štern, Tomaž Vrtovec, Vane Antolič, Rok Vengust

Published in: International Orthopaedics | Issue 4/2015

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Abstract

Purpose

Percutaneous vertebroplasty is a widely used vertebral augmentation technique. It is a minimally invasive and low-risk procedure, but has some disadvantages with a relatively high number of bone cement leaks and adjacent vertebral fractures. The aim of this cadaveric study was to determine the minimum percentage of cement fill volume in vertebroplasty needed to restore vertebral stiffness and adjacent intradiscal pressure.

Methods

Thirteen thoracolumbar spine mobile segments were loaded to induce a vertebral fracture. After fracture vertebroplasty was performed, four times in the same fractured vertebra. The injected cement volume was 5 % of the fractured vertebral volume to reach 5, 10, 15 and 20 % of cement fill. Biomechanical testing was performed before the fracture, after the fracture and after each cement injection.

Results

After vertebral fracture compressive stiffness was reduced to 47 % of the pre-fracture value and was partially restored to 61 % after 10 % cement fill. With vertebroplasty intradiscal pressure gradually increased, depending on specimen position, from 48 to a total of 71 % at 15 % of cement fill.

Conclusions

Compressive stiffness and intradiscal pressure increase with the percentage of cement fill. Fifteen per cent of cement fill was the limit beyond which no substantial increase in compressive stiffness or intradiscal pressure could be detected and is the minimum volume of cement we recommend for vertebroplasty. In the average thoracolumbar vertebra this means 4–6 ml of cement.
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Metadata
Title
Minimum cement volume for vertebroplasty
Authors
David Martinčič
Miha Brojan
Franc Kosel
Darko Štern
Tomaž Vrtovec
Vane Antolič
Rok Vengust
Publication date
01-04-2015
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 4/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-014-2620-7

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