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Comparison Between Radiofrequency Targeted Verterbal Augmentation, Balloon Kyphoplasty and Vertebroplasty using high viscosity cement in treatment of vertebral Compression fractures 2012

Interventional Spine

Bassem, A, Georgy, MD

Paper/Non-Mentor

Purpose

Both vertebroplasty and balloon kyphoplasty have been described for treatment of vertebral compression fractures. This study compares the incidence and pattern of cement leakage in cases treated with high-viscosity cement vertebroplasty (HVC-VP), standard balloon kyphoplasty (BKP) and a novel targeted vertebral augmentation procedure, Radiofrequency Targeted Vertebral Augmentation (RF-TVA). RF-TVA allows targeted and controlled delivery of Radiofrequency activated (high-viscosity) cement using a uipedicular access and a midline osteotome.

Methods & Materials

Retrospective analysis of postoperative radiographs of patients treated with the three cement augmentation techniques were analyzed for the incidence and location of cement leakage. 112 consecutive patients with 159 treated levels were included in this review. There were 66 HVC-VP levels and 46 levels in BKP and 47 levels in RF-TVA groups treated ranged from T3 to L5.

Results

In the HVC-VP group, a total of 33 leakages were reported (17 discal, 11 venous, 4 paravaertebral and 1 epidural). In the BKP group a total of 31 leakages were reported (15 discal, 11 venous, 3 paravaertebral and 2 epidural). In the RF-TVA group a total of 16 leakages were reported, (8 discal, 5 venous, 3 paravaertebral and non epidural). No significant leakage that required any surgical intervention was noted.

Conclusion

These finding shows that targeted cement augmentation using RF-TVA technique may provide approximately 50% reduction in leakage rate when compared to conventional VP using high viscosity cement and standard BKP. These results may be related to the unique combination of controlled delivery of radiofrequency activated (very high viscosity) cement at a fixed low rate of injection into site-specific channels created using a navigational osteotome. RFK allows uni-pedicular access and remotely controlled cement delivery to decrease procedural invasiveness and physician radiation exposure, respectively.

References/Financial Disclosures

Consultant; DePuy spine Dfine Spine