Elastoplasty: first experience in 12 patients.

Area of Science:

• Interventional Radiology
• Biomaterials Science
• Orthopedic Surgery

Background:

• Percutaneous vertebroplasty with polymethylmethacrylate (PMMA) is a common treatment for vertebral compression fractures.
• Restoring vertebral stiffness with PMMA may cause secondary fractures in adjacent vertebrae.
• Elastoplasty is explored as an alternative to potentially prevent these secondary fractures.

Purpose of the Study:

• To retrospectively assess the safety and efficacy of elastoplasty using VK100 silicone cement in patients with vertebral compression fractures.
• To evaluate the incidence of silicone migration, specifically silicone pulmonary embolism and perivertebral leakage.
• To compare the complication rates with those of traditional PMMA vertebroplasty.

Main Methods:

• A retrospective review of 12 patients undergoing elastoplasty between July 2011 and January 2012.
• Exclusion criterion: posterior wall defects.
• Postprocedural chest computed tomography (CT) scans were used to detect perivertebral leakage and pulmonary embolism.

Main Results:

• Twenty-one vertebral bodies were treated in 12 patients.
• Silicone pulmonary emboli were detected in 60% of patients.
• Perivertebral venous plexus leakage occurred in 67% of treated vertebrae.
• One patient experienced severe dyspnea due to multiple peripheral silicone emboli.

Conclusions:

• VK100 silicone cement elastoplasty is associated with a high risk of silicone pulmonary embolism, exceeding that of PMMA.
• The slow setting time of VK100 silicone cement poses a technical challenge for clinical application.
• Current evidence suggests against the use of VK100 silicone cement for elastoplasty.