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Coblation vertebroplasty for complex vertebral insufficiency fractures
David J Wilson1, Sara Owen, Rufus A Corkill
1St Lukes Radiology, St Lukes Hospital, Latimer Rd, Headington, Oxford, OX3 7PF, UK. david.wilson@ndorms.ox.ac.uk
European Radiology
|February 28, 2013
Summary
Coblation before vertebroplasty creates a cavity for safer cement injection in complex vertebral fractures, reducing risks. This technique benefits patients previously unsuitable for standard vertebroplasty, with no observed complications.
Area of Science:
- Spinal surgery
- Orthopedic oncology
- Trauma surgery
Background:
- Vertebral compression fractures, especially with posterior wall defects, present treatment challenges.
- Traditional vertebroplasty carries risks, including cement extravasation into the spinal canal.
Purpose of the Study:
- To evaluate the safety and efficacy of using coblation to create a cavity before vertebroplasty for complex vertebral fractures.
- To assess the potential of this technique to reduce cement extravasation and enable treatment for previously unsuitable patients.
Main Methods:
- A prospective audit of 32 coblation-assisted vertebroplasty procedures was conducted.
- Coblation created a cavity in the vertebral body prior to cement injection.
- Pain and mobility were assessed using visual analogue and Roland Morris scales.
Main Results:
- The study included patients with myeloma, metastases, osteoporosis, and trauma.
- A 56% success rate was observed, with 32% showing mixed but mainly positive results.
- No neurological damage or subsequent fractures at treated levels occurred.
Conclusions:
- Coblation-assisted vertebroplasty is a viable option for complex vertebral fractures, including those with posterior wall defects.
- The technique facilitates low-pressure cement injection, mitigating extravasation risks.
- This method expands treatment possibilities for patients unsuitable for conventional vertebroplasty.
