[Vertebroplasty in severe osteoporosis. Technique and experience with multi-segment injection]

Area of Science:

• Orthopedics
• Neurosurgery
• Radiology

Background:

• Severe osteoporosis often leads to progressive vertebral collapse, a challenge not adequately addressed by traditional medical treatments.
• Existing vertebroplasty techniques have evolved, prompting exploration of more extensive cement injections for improved outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of extensive, multi-level percutaneous cement injections for treating severe osteoporosis with vertebral collapse.
• To assess the impact of this procedure on pain reduction, functional improvement, and radiological stability.

Main Methods:

• A retrospective analysis of 362 patients treated with percutaneous cement injection over five years.
• Focus on 100 patients who underwent injections at five or more vertebral levels (average 7.3 levels).
• Refined surgical technique allowed unilateral injection of up to six levels under local anesthesia, with cement volume limited per session.

Main Results:

• 84% of patients reported favorable outcomes with significant pain reduction (Visual Analog Scale from 7.6 to 2.7).
• Patients subjectively reported improved posture, increased back strength, and enhanced physical activity.
• One-year radiological follow-up demonstrated stable vertebral integrity and maintained intervertebral disc space.

Conclusions:

• Multi-level vertebroplasty is an efficient procedure for preventing further vertebral collapse in severe osteoporosis.
• Limiting injections to six levels per session is recommended to mitigate the risk of fat embolism.