Dimitrios Filippiadis MD, PhD, Presenter: Nothing to Disclose

Georgios Velonakis MD, Abstract Co-Author: Nothing to Disclose

Argyro Mazioti MD, Abstract Co-Author: Nothing to Disclose

Elias Brountzos MD, Abstract Co-Author: Nothing to Disclose

Nikolaos L. Kelekis MD, Abstract Co-Author: Nothing to Disclose

Alexios Kelekis MD, PhD, Abstract Co-Author: Consultant, Benvenue Medical, Inc

To compare safety, efficacy and long term stability between standard and augmented vertebroplasty in patients with symptomatic extreme vertebral fractures (split or incomplete burst vertebral fractures or large osteonecrotic vertebral cavities).

During the last 36 months, we prospectively studied and compared 2 groups (12 patients each) suffering from painful extreme vertebral fractures. Group A underwent standard vertebroplasty. Group B underwent augmented vertebroplasty with implantation of biocompatible peek cage (KIVA implant). Standard x rays and CT scans were performed during follow-up. Pain prior, the morning after and at the last follow-up (average follow-up 12 months) were compared by means of numeric visual scale (NVS) questionnaire. Cement or implant migration were recorded. Statistical analysis was performed with Chi-Square Tests, Related Samples Wilcoxon Signed Rank Tests and Tests of within Subjects Effects.  

In Group A, there was progress of the vertebral body damage (including widening of the fracture line or PMMA migration and subsequent vertebral fracture) in 3/12 patients (25%) with 2/12 being surgically operated (16.7%). In Group B there was no implant change or migration observed. No symptomatic or clinically significant extravasations occurred in both Groups. Group A presented a mean pain value of 9.00±1.04 prior and 2.33±3.74 NVS units post treatment, with a mean decrease of 6.67±1.49 NVS units (p=0.005). Group B presented a mean pain value of 8.66±1.07 prior and 1.33±1.55 NVS units post treatment, with a mean decrease of 7.33±1.49 NVS units (p=0.002). Pain reduction difference between the two Groups was not statistically significant (p=0.545). PMMA versus implant migration in the two groups was marginally insignificant in the statistic analysis (p=0.064). Overall mobility improved in 10/12 patients in Group A and 12/12 patients in Group B.  

Both standard and augmented vertebroplasty seem to be effective concerning pain reduction in patients with split or incomplete burst vertebral fractures or large osteonecrotic vertebral cavities. Preliminary results show potential tendency for widening of fracture line or PMMA migration and subsequent vertebral fracture in the vertebroplasty Group. 

In augmented vertebroplasty, the implant seems to function as internal cast providing mechanical and structural support and height restoration.

Filippiadis, D, Velonakis, G, Mazioti, A, Brountzos, E, Kelekis, N, Kelekis, A, Prospective Randomized Comparative Trial between Standard and Augmented Vertebroplasty in Extreme Vertebral Fractures (Split or Incomplete Burst Fractures and Large Osteonecrotic Cavities).  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011472.html