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Spinal Instrumentation Rescue with Cement Augmentation
A Cianfoni1,2, M Giamundo3, M Pileggi4
1From the Departments of Neuroradiology (A.C., M.P., M.I.) alessandro.cianfoni@eoc.ch.
AJNR. American Journal of Neuroradiology
|September 15, 2018
Summary
Percutaneous vertebral cement augmentation is a feasible and safe minimally invasive treatment for spinal instrumentation failure. This procedure effectively avoids revision surgery in 82% of patients, offering significant pain relief.
Area of Science:
- Orthopedics
- Neurosurgery
- Radiology
Background:
- Spine instrumentation failure can result from altered biomechanics or bone fragility.
- Revision surgery is often necessary but minimally invasive alternatives are being explored.
Purpose of the Study:
- To evaluate the feasibility, safety, and efficacy of percutaneous fluoroscopically guided vertebral cement augmentation for spinal instrumentation failure.
- To assess the rate of revision surgery avoidance and clinical outcomes in patients undergoing this procedure.
Main Methods:
- A series of 31 vertebral augmentation procedures were performed in 29 patients.
- Indications included screw loosening, cage subsidence, and fractures within or adjacent to instrumented segments.
- Feasibility, safety, and clinical effect (Patient Global Impression of Change) were prospectively recorded.
Main Results:
- All procedures except one were technically feasible, with no periprocedural complications.
- Revision surgery was avoided in 82% of patients.
- 87% of patients reported global clinical benefit at 1-month follow-up.
Conclusions:
- Percutaneous vertebral augmentation is a feasible treatment for spinal instrumentation failure.
- The procedure demonstrates excellent safety and efficacy in avoiding revision surgery and palliating pain.
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