Safety and results of image-guided vertebroplasty with elastomeric polymer material (elastoplasty)

Giovanni Mauri,Guido Bonomo,Gianluca Maria Varano,Paolo Della Vigna,Franco Orsi,Luca Maria Sconfienza,Giovanni Carlo Anselmetti,Luca Nicosia

doi:10.1186/s41747-018-0062-5

Giovanni Mauri, Guido Bonomo + Show 6 more

Open Access

https://doi.org/10.1186/s41747-018-0062-5

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Abstract

BackgroundImage-guided elastoplasty is an innovative method for percutaneous vertebral augmentation with a silicone elastomeric material. Our aim was to evaluate its technical success, safety and efficacy as well as the rate of secondary fractures.MethodsNineteen patients (13 women and 6 men, age 72 ± 10 years, mean ± standard deviation) underwent elastoplasty between 2010 and 2016. A total of 33 vertebrae were treated. A total of 2–6 mL of silicone-based elastomeric polymer material (VK100) was used. Visual analogue scale (VAS) and Oswestry disability index (ODI) pain scores were used.ResultsIn all cases, it was possible to complete the procedure (technical success 100%). No major complications occurred. In 6/19 (31.5%) patients, asymptomatic leakage of the material was observed during the procedure. Full pain recovery was obtained in 18/19 (94%) patients. One patient with a painful angioma did not experience any change in symptoms. VAS and ODI were significantly reduced after the procedure, from 7.9 ± 1.1 to 0.7 ± 1.4 and from 79.6 ± 12% to 9.9 ± 14% respectively (p < 0.001 for both comparisons). After vertebroplasty, 14 of 15 patients (93%) removed the brace and 16/19 (84%) completely stopped using any drugs for pain relief (p < 0.001 for both pre-procedure versus post-procedure comparisons). At a mean follow-up time of 26.5 ± 28.1 months (median 8.7 months, range 6–69 months), no secondary fracture occurred.ConclusionTaking into consideration the relatively small sample size, image-guided elastoplasty seems to be a safe procedure providing effective pain control over time.

Highlights

Image-guided elastoplasty is an innovative method for percutaneous vertebral augmentation with a silicone elastomeric material
From 2003 to 2016, 4580 patients with back pain and different kinds of vertebral lesions were presented to the same interventional radiologist with more than 13 years of experience; they were treated by percutaneous vertebral augmentation at different institutions
Patients with no more than two vertebral fractures were selected for elastoplasty and prepared for treatment at one of the institutions where the material was available

Summary

Introduction

Image-guided elastoplasty is an innovative method for percutaneous vertebral augmentation with a silicone elastomeric material. Percutaneous vertebral augmentation is increasingly used to achieve vertebral stabilisation and pain relief from symptomatic vertebral lesions. With this technique, the stiffness of the vertebral body is rapidly restored, reporting significant pain relief and improvement in quality of life [1,2,3,4]. The most widely used method for vertebral augmentation is vertebroplasty, which involves injection of surgical bone cement. To this aim, polymethylmethacrylate (PMMA) [5] presents a good characteristic in terms of viscosity, polymerisation time and mechanical resistance.

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