A biomechanical analysis of intravertebral pressures during vertebroplasty of cadaveric spines with and without simulated XXXX .

@entity154 @entity75 @entity5 @entity170 @entity887 @entity1745 @entity3 @entity614
STUDY DESIGN: A biomechanical cadaveric study of thoracic and lumbar vertebrae with simulated @entity3 quantifying intravertebral pressures during transpedicular vertebroplasty. OBJECTIVE: To compare intravertebral pressures during percutaneous vertebroplasty in vertebrae with and without simulated lytic @entity3 . SUMMARY OF BACKGROUND DATA: Percutaneous vertebroplasty is designed to provide stability to vertebrae weakened by @entity170 or @entity3 . The complication rate is higher when the procedure is used for the treatment of @entity75 . The major complications reported are @entity614 , @entity1745 , and @entity887 . METHODS: Ten fresh-frozen cadaveric vertebrae were tested intact (7 lumbar, 3 thoracic) and 7 were tested with simulated @entity154 (4 lumbar, 3 thoracic). Defects were created by replacing a core of cancellous bone with soft @entity5 tissue in the center of the vertebral body. Simplex P (Howmedica Osteonics, Mahwah, NJ) cement was injected into each vertebra through a unipedicular approach at a constant rate of 3 mL per minute. Cement volume, injection force, and intravertebral pressures at the posterior vertebral body wall were recorded. Following the procedure, the vertebrae were sectioned to visualize cement and @entity5 disbursement. RESULTS: There was no significant difference between the two groups for age, size, trabecular density, and cement volume. Vertebrae with simulated @entity3 generated an average maximum pressure of 39.66 kPa during cement injection versus 6.83 kPa in intact vertebrae (P < 0.05). Higher pressures were also generated in smaller vertebrae based on a power relationship (r2 = 0.71 intact, r2 = 0.43 @entity5 ). CONCLUSIONS: Percutaneous vertebroplasty produces higher intravertebral pressures in vertebrae containing a simulated lytic metastasis than in intact vertebrae. Pressures generated in the @entity5 specimens are sufficiently elevated to cause @entity887 .
