• Y J Kwon.
• Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. neuriac@skku.edu
• Minim Invas Neurosur. 2008 Jun 1; 51 (3): 187-91.

ObjectiveOne of the main limitations of vertebroplasty is the excessive pressure required for injection of sufficient cement into a vertebral body. Kyphoplasty can be used to reduce injection pressure by making a void with a balloon tamp. The author presents a technique of making small voids to reduce cement delivery pressure during vertebroplasty that involves a simple modification of the conventional technique.MethodsThe author performed this modified vertebroplasty in 48 patients with an acute vertebral compression fracture. Small voids and micro-connections with the fracture gaps in the vertebral body were created using a curved probe placed into the vertebral body through a working cannula. Visual analogue scale (VAS) scores were measured preoperatively and at 1 week and 3 months postoperatively. Forty patients with osteoporotic VCFs were followed for a mean period of 6months.ResultsAll 48 patients showed a significant reduction in visual analogue pain scores at 1 week and 3 months postoperatively versus preoperative levels (p<0.001, respectively). No device-related complications or major cement leakages that caused postoperative neurological deficits or pulmonary complications were noted.ConclusionThe described modification of vertebroplasty involving the creation of small cavities using a curved probe appears to control cement injection easily during the procedures and minimize cement leakage-related complications.

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