Abstract

Aim: To evaluate of the effectiveness of contrast injection before the cement application in the vertebroplasty procedure. Background Data: Cement leakage is a common problem during percutaneous vertebroplasty and can lead to complications such as pulmonary embolism, nevre root and cord compression. Between 38-85 % of cement leakage rate has been reported during vertebroplasty procedures. Materials and Methods: Thirthy percutaneous vertebroplasty procedures had been done between 2005-2007 in our department. Of these four cases were metastatic or primary tumor of vertebral column. Rest of the patients were suffered from osteoporotic vertebral fractures. Eighteen were female and nine were male. The average age was 72 (41-87). Mean follow-up was 17 months (3-51). Non-ionic contrast media injection was performed as an integral part of procedure to the all of the patient. 2 mlt of contrast media was injected after the placement of Jam-sheedy needle transpedicularly to the vertebral corpus. Results: VAS and Oswestry scores were used for the clinical evalution. For the radiological assesment the sagital index was measured for all the patients preoperatively, postopertively and in the last follow-up. VAS and Oswestry scores were improved in most of the patients significantly (p<0.05). There were no significant difference between the preoperative and postoperative radiographic measurements (p>0.05). In only one patient had contrast leakage to the epidural space. In this patient, cement was injected only from the contralateral side. No patient has allergic reaction because of the contrast media. Discussion and Conclusion: Non-ionic contrast media injection seems to be an effective and safe trick of trade for the prevention of the cement leakage in percutaneous vertebroplasty.