Carla Alexis de Venecia MD, Presenter: Nothing to Disclose

Bhumika Patel MS, Abstract Co-Author: Nothing to Disclose

A. Orlando Ortiz MD, MBA, Abstract Co-Author: Speakers Bureau, Medtronic, Inc Speakers Bureau, Stryker Corporation

To assess the utility and efficacy of a semipermeable mesh implant (Soteira Corp, Natick, MA) in the performance of vertebral augmentation.

The semipermeable mesh implant is a collapsible, self-expanding stent device with a braided primary structure and flow directing features used with bone cement to treat osteoporotic vertebral compression fractures. Following the creation of a cavity using a coaxially inserted directional curved curette, the stent is inserted into the intravertebral cavity. The primary structure of the implant maintains the patency of the cavity without compacting surrounding cancellous bone. Acrylic bone cement (polymethylmethacrylate) is then subsequently injected into the cavity through the deployed mesh stent, and the flow-directing features of the stent allow control of the cement delivery. The device was utilized by a single operator in 5 patients who were treated for painful osteoporotic vertebral compression fractures. The device was assessed for ease of use, subsequent cement distribution and any device or procedure related complications. 

5 patients, including 1 male and 4 females, with an average patient age of 78 years were included in the study. The semipermeable mesh implant was used to treat one fractured vertebra in each patient. The levels treated were L1 in two patients and L2 in three patients. As a result of coaxial technique the device was readily exchanged over a guidepin and prompt vertebral body access was feasible in all cases. A unilateral transpedicular approach was used in all cases. An average of 2 passes with the curette was required to create a cavity within the vertebra. Cement distribution patterns showed a positive correlation with the deployment of the semipermeable mesh implant. The average cement volume utilized was 2 mL. There was no cement extravasation and there were no procedure related complications.

The semipermeable mesh implant showed a safe and reliable performance in the treatment of osteoporotic vertebral compression fractures in the lumbar spine. Its use is associated with controlled and directed cement delivery.  

The described semipermeable mesh implant would allow for more even cement distribution during vertebroplasty and thus potentially improve the durability of vertebral augmentation.

de Venecia, C, Patel, B, Ortiz, A, Use and Evaluation of a Semipermeable Mesh Implant for Vertebral Augmentation in the Treatment of Lumbar Osteoporotic Vertebral Compression Fractures.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12038224.html