Abstract

BackgroundThe cement flow is difficult to check and control with conventional Vertebroplasty and the complications resulting may include leakages of the cement into the spinal canal. However the Kyphoplasty is more secure but the cost are very high. That’s why we developed a new Technique which is standing between the Vertebroplasty and the Kyphoplasty.Methods: With the Spongioplasty Concept, the loss of spongiosa and trabecula is more homogeneously balanced. For this purpose a percutaneous route in local or general anesthesia with the help of special access instruments is performed with a dorsal approach, pivotally transpedicular or extrapedicular, to the vertebral body. This is carried out under X-ray C-arm image control in 2 planes or optional with spinal navigation. The repositioning is made by corresponding ventral sag of the spinal column, when positioning the patient. With the instruments correctly placed a bilateral biopsy is taken by suction of spongiosa. This creates a cylindrical space (3mm x 3mm x 35 mm) in the vertebral body that allows for an optimal distribution of the bone cement. Under X-ray C-arm image control the viscous bone cement is then delivered in the vertebral body by a special applicator. The cement (PMMA) hardens inside in a few minutes. Through this it comes to an interior stabilization of the bone and pain relief.Indications: Fresh osteoporotic fractures of lumbar, thoracic and cervical spine, tumors and vertebral haemangioma.Results: We have operated 109 patients, 80 female patients and 29 male patients. In the majority it was fresh osteoporotic fractures n= 97. Prae-operatively 91% of the patients had severe till unbearable pains and 92% of the patients had post-operatively non to moderate pains. A reposition could be obtained from at least 2° (2° to 8°) in 47.6% of the patients. Clinical relevant complications occurred in 0.9% of the patients. Conclusion: Fresh osteoporotic fractures have a good follow up after percutaneous Spongioplasty.The Spongioplasty is a very safety and cost-effective method which biomechanical allows a good cement distribution. Furthermore we reached through the ventral sag position of the patient a repositioning of the vertebra fracture.