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The Effectiveness of Gelfoam Technique before Percutaneous Vertebroplasy: Is It Helpful for Prevention of Cement Leakage? A Prospective Randomized Control Study

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Abstract
Objective
Preinjection gelfoam embolization during percutaneous vertebroplasty (PVP) has been thought alternative technique to prevent the leakage of bone cement. The goal of this study was to evaluate whether the gelfoam techniques are useful to reduce bone cement leakage.
Methods
Total 100 PVPs of osteoporotic spine compression fractures were performed by 1 spine surgeon who experienced more than 500 PVP cases under prospective control study. Operation was done in T-L junction (T10-L2) fractures with bi-transpedicular approach. Preinjection gelfoam PVP was done in the 50 levels. As control group, PVP without gelfoam was done in the 50 levels. We did not perform preoperative venography. We inserted normal saline-mixed gelfoam to the anterior third of vertebral body via PVP needle, and then 3mL of polymethylmetacrylate (PMMA) was injected. We prospectively evaluated the incidence and leakage pattern of PMMA by postoperative computed tomography.
Results
Between gelfoam and control groups, there were 11 leaks (22%) versus 12 leaks (26%). The mean operation time was 7.00 minutes versus 6.30 minutes. In gelfoam group, there were 6 spinal canal leaks, 4 paravertebral venous leaks, and 1 soft tissue leaks. In control group, there were 4 spinal canal leaks, 8 paravertebral venous leaks, and 1 disc space leak. In spite of cement leakage, there was no symptomatic case in both groups. Statistically, gelfoam technique was not related to decrease the incidence of leakage (p=0.64).
Conclusion
Our prospective study showed that it did not significantly decrease cement leakage when vertebroplasty is performed by experienced spine surgeon.
All Author(s)
J. S. Oh ; J. W. Doh ; J. J. Shim ; K. S. Lee ; S. M. Yoon ; H. G. Bae
Issued Date
2016
Type
Article
Keyword
VertebroplastyGelfoamOsteoporotic fractureSpine fractures
Publisher
대한척추신경외과학회
The Korean Spinal Neurosurgery Society
ISSN
1738-2262 ; 2093-6729 ; 2586-6591 ; 2586-6583
Citation Title
Korean Journal of Spine
Citation Volume
13
Citation Number
2
Citation Start Page
63
Citation End Page
66
Language(ISO)
eng
DOI
10.14245/kjs.2016.13.2.63
URI
http://schca-ir.schmc.ac.kr/handle/2022.oak/2691
Appears in Collections:
신경외과 > 1. Journal Papers
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