Abstract
Injection of PMMA bone cement into fractured vertebral bodies has been used clinically and proved to be effective. However, there are concerns about thermal injury to the cord and interferece of bone remodling .The purpose of this study is to use the biodegradable bone substitute as an alternative for augumentation of fractured vertebral bodies .
Material and Methods: From April 1998 to January 2000, 10 patients(Nine females and one male, age from 55 to 74 years) with osteoporotic compression fractures were retrospectively reviewed. The level of compression fracture mostly occurred at T12-L1 (Nine of ten cases). Eight of the ten cases were osteonecrosis of vertebral body with vaccum phenomenon. While other two cases had gross kyphotic deformity. Surgical indications for these ten patients include back pain, progressive kyphosis and failure of conservative medical treatment. (No neurological deficits were noted in all ten cases.) All ten cases underwent posterior instrumentation with vertebroplasty (Bipedicle impaction of osteoset and iliac bone autograft). The anterior body height and the kyphotic angle were measured preoperatively and postoperatively. The fusion mass was observed and followed up with T-L spine AP and Lateral X-ray regularly.
Result: The anterior body height increased over 50% in all cases in this series. The average correction of kyphosis angle is 10 degree. Stable arthrodesis with obvious fusion mass occurred in all patients under X-ray image. Postoperative pain relief were noted in all ten patients. No major complications were related to this procedure.
Conclusion: This preliminary study shows that vertebroplasty using osteoconductive biodegradable bone substitute and osteoinductive iliac bone autograft in osteoporotic compression fracture with osteonecrosis is feasable and effective. The technique might also provide an alternative for treatment of osteoporotic compression fractures instead of PMMA bone cement.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
