Volume 15 | Issue 2 | Apr-Jun 2020 | Page 16-21 | Sanjeev Motilal Bhandari, Siddharth Sanjeev Bhandari, Mahadeo Manaji Ghuge
Authers: Sanjeev Motilal Bhandari [1], Siddharth Sanjeev Bhandari [1], Mahadeo Manaji Ghuge [1]
[1] Department of Orthopaedics, Dr.V.M.Government Medical College, Solapur.
Address of Correspondence
Dr. Sanjeev Motilal Bhandari
Department of Orthopaedics,
Bhandari Hospital, 146, Railway Lines,
Solapur – 413001 ( Maharashtra ) India
E-mail: drsmbhandari@gmail.com
Abstract
Background: Percutaneous Vertebroplasty (PVP) is an established procedure for vertebral compression fractures (VCF) in elderly due to osteoporosis and vertebral neoplasms. Here we want to share a few practical tips for good results, avoiding potential complications.
Materials & Methods: 156 patients having 172 VCFs, not responding to conservative treatment, were included in this prospective study from 2012 to 2019. Under local anesthesia, bipedicular entry was taken over 2 mm guide wires using Jamshidi needles. After core biopsy in doubtful aetiology, about 3 to 5 ml of pre-cooled PMMA cement was injected, after contrast injection to check for any leakage. The mean duration of follow-up was 16.2 months, ranging from minimum 12 months to 8 years. Visual analogue scale (VAS) score and Oswestry Disability Index (ODI) were used to evaluate pain relief after PVP.
Results: All patients had immediate relief from disabling pain and could be mobilized immediately. VAS Score improved from mean pre-PVP score of 7.8 (range 6-9) to 2.8 (range 0-5) and 3.2 (range 0-6) at 1 week and 1 year postoperative respectively. Similarly ODI improved from 72% to 29% at 1 year follow-up. The complication rate was 6.3%, which included cement leakage (2.5%; n=4), suboptimal cement filling (2.5%; n=4), deep infection (0.64%; n=1) and late cement extrusion in canal (0.64%; n=1).
Conclusions: For VCFs, PVP is a cost-effective minimally invasive procedure with immediate pain relief and low incidence of complications. Employing a few modifications in technique, the complications can be further reduced with uniform good results.
Keywords: Vertebral fractures, Percutaneous vertebroplasty, Guide wire, Bipedicular technique, Contrast injection
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| How to Cite this article: Bhandari S M, Bhandari S S, Ghuge M M. Percutaneous Vertebroplasty for Vertebral Compression Fractures – Practical Tips for Successful Outcome. Journal of Trauma and Orthopaedic Surgery. April – Jun 2020;15(2):16-21. |