Vertebral augmentation: How we do it

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Techniques in Vascular and Interventional Radiology Pub Date : 2024-09-01 DOI:10.1016/j.tvir.2024.100979
Junaid Raja MD MSPH , Jake DiFatta BS , Junjian Huang MD , Dana Dunleavy MD
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Abstract

Vertebral augmentation consists of minimally invasive techniques indicated in the treatment of vertebral compression fractures (VCFs). These compression fractures cause vertebral body height loss and consequent significant pain and are most frequently the result of osteoporosis, cancer metastasis, or trauma. The deleterious effects of VCFs often compound, as greater load-bearing stress is transferred to the remaining healthy vertebrae. Kyphoplasty, vertebroplasty, and intravertebral implants are closely related vertebral augmentation techniques that serve to relieve pain and to counter pathophysiological stress and structural degradation of the vertebral column alignment. All 3 approaches are performed percutaneously and are therefore attractive options for patients deemed to be poor candidates for open surgery.
Each technique involves transpedicular needle access to the vertebral body matrix, followed by introduction of a cement-like polymer through a catheter to fill the space and provide structural fortification. Vertebroplasty involves injection of the cement material into the matrix space without any adjunctive measures. In kyphoplasty, a balloon is first introduced to expand the collapsed, fractured area with the goal of approximating the prefracture anatomy of the vertebral body and thereby spinal curvature, promptly followed by cement introduction. In intravertebral implantation procedures, a permanent jack is inserted into the vertebral body matrix and expanded craniocaudally, with the same purpose of restoring normal structure, before the matrix space is filled with cement polymer. This article provides an overview of these vertebral augmentation techniques, including pre and postprocedural considerations, with an emphasis on the technical aspects of the interventions.
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椎体增强术:我们是如何做到的
椎体增量术包括用于治疗椎体压缩性骨折(VCF)的微创技术。椎体压缩性骨折会导致椎体高度降低,从而引起剧烈疼痛,最常见的原因是骨质疏松症、癌症转移或外伤。由于更大的承重压力会转移到剩余的健康椎体上,因此 VCF 的有害影响往往会加重。椎体成形术(Kyphoplasty)、椎体成形术(Verbroplasty)和椎体内植入物(Intraverbral implants)是密切相关的椎体增强技术,可缓解疼痛,对抗病理生理压力和椎体排列结构退化。这三种方法都是经皮进行的,因此对于不适合进行开放手术的患者来说是很有吸引力的选择。每种技术都涉及经皮穿刺针进入椎体基质,然后通过导管导入类似水泥的聚合物,以填充空间并提供结构加固。椎体成形术是将骨水泥材料注入基质间隙,不采取任何辅助措施。在椎体后凸成形术中,首先引入一个球囊以扩大塌陷的骨折区域,目的是接近椎体骨折前的解剖结构,从而使脊柱弯曲,随后迅速引入骨水泥。在椎体内植入手术中,先将永久性千斤顶插入椎体基质并向颅内扩张,目的同样是恢复正常结构,然后再用骨水泥聚合物填充基质空间。本文概述了这些椎体增量技术,包括术前和术后的注意事项,重点介绍了介入的技术方面。
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来源期刊
Techniques in Vascular and Interventional Radiology
Techniques in Vascular and Interventional Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
2.70
自引率
0.00%
发文量
47
期刊介绍: Interventional radiology is an area of clinical diagnosis and management that is highly technique-oriented. Therefore, the format of this quarterly journal, which combines the visual impact of an atlas with the currency of a journal, lends itself perfectly to presenting the topics. Each issue is guest edited by a leader in the field and is focused on a single clinical technique or problem. The presentation is enhanced by superb illustrations and descriptive narrative outlining the steps of a particular procedure. Interventional radiologists, neuroradiologists, vascular surgeons and neurosurgeons will find this a useful addition to the clinical literature.
期刊最新文献
Editorial Board Percutaneous spinal decompression Epidural steroid injection technique The importance of advanced image guided pain management and the role of interventional radiology Vertebral augmentation: How we do it
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