Percutaneous Vertebroplasty and Kyphoplasty
Second Edition
Percutaneous Vertebroplasty and Kyphoplasty
Second Edition
John M. Mathis, MD, MSc
Professor and Chairman, Department of Radiology, Virginia College of Osteopathic Medicine, Blacksburg, Virginia; Medical Director, Centers for Advanced Imaging, Roanoke, Virginia
Hervé Deramond, MD
Service d’imagerie médicale, Centre Hospitalier Universitaire de Fort de France, Hopital Pierre Zobda-Quitman, Fort de France, France
Stephen M. Belkoff, PhD
Associate Professor, Director, Biomechanical Instrumentation Laboratory, Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, Maryland
Editors
John M. Mathis, MD, MSc Professor and Chairman Department of Radiology Virginia College of Osteopathic
Medicine Blacksburg, VA and
Medical Director
Centers for Advanced Imaging Roanoke, VA
USA
Stephen M. Belkoff, PhD Associate Professor Director
Biomechanical Instrumentation Laboratory
Department of Orthopedic Surgery
Johns Hopkins University Baltimore, MD
USA
Library of Congress Control Number: 2005932543
ISBN-10: 0-387-29078-8 ISBN-13: 978-0387-29078-2 Printed on acid-free paper.
© 2006, 2002 Springer Science+Business Media, Inc.
All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, Inc., 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden.
The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not iden- tified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights.
While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
Printed in China. (BS/EVB) 9 8 7 6 5 4 3 2 1
springer.com
Hervé Deramond, MD Service d’imagerie médicale Centre Hospitalier
Universitaire de Fort de France
Hopital Pierre Zobda-Quitman Fort de France
France
Preface
v
Since the first edition of this book was published in 2002, there have
been many advances in our knowledge of percutaneous vertoplasty (PV), particularly about how to perform the procedure more safely and how to approach more complex case situations. Additionally, materi- als that were initially used “off label” or that simply were not FDA approved have completed their governmental review and have received FDA approval. This has increased the legitimacy of the pro- cedure from the legal and reimbursement perspective.
Controversy over height restoration and device selection has become a progressively bigger issue over time. Kyphoplasty (balloon assisted vertebroplasty) has received tremendous emphasis. This book com- pares and contrasts data and claims that differentiate kyphoplasty from percutaneous vertebroplasty. We also look at other methods that poten- tially can be used for height restoration.
New procedures that deal with bone augmentation in other anatomic regions have evolved (i.e., sacroplasty) and are discussed. As this revo- lution in image-guided percutaneous bone augmentation has devel- oped, multiple medical specialties have embraced these procedures in their training programs for both residents and practicing physicians.
All these factors have contributed to the need for an updated edition of the book that encompasses new developments in the field of percu- taneous bone augmentation and compares and contrasts the various procedures that are in use world wide. It presents recommendations by national societies that have published “Standards of Practice.” Com- plications, that have become more apparent since the procedures incep- tion, are discussed in detail along with methods for their avoidance.
Finally, this edition presents cases that the student or practitioner may likely face and describes the methods used to analyze and treat these various problems.
It has been our pleasure and honor to be associated with the devel- opment, dissemination, and investigation of these various procedures and the materials that are used to accomplish the numerous types of image-guided bone augmentations discussed.
John M. Mathis, MD, MSc
Hervé Dermond, MD
Stephen M. Belkoff, PhD
Contents
vii
Preface . . . . v
Contributors . . . . xi
Section I Basic Science and Techniques
Chapter 1 History and Early Development of Percutaneous Vertebroplasty . . . . 3 John M. Mathis, Stephen M. Belkoff,
and Hervé Deramond
Chapter 2 Spine Anatomy . . . . 8 John M. Mathis
Chapter 3 The Medical Management of Bone Health
and Osteoporosis . . . . 33 Michele F. Bellantoni
Chapter 4 Surgical Options for Vertebral Compression
Fractures . . . . 51 Aleksandar Curcin and Richard Henrys
Chapter 5 Patient Evaluation and Selection . . . . 60 M.J.B. Stallmeyer and Gregg H. Zoarski
Chapter 6 Biomechanical Considerations . . . . 89 Stephen M. Belkoff
Chapter 7 Percutaneous Vertebroplasty: Procedure
Technique . . . . 112 John M. Mathis
Chapter 8 Balloon Kyphoplasty and Lordoplasty . . . . 134
Paul F. Heini, René Orler, and Bronek Boszczyck
Chapter 9 Vertebroplasty Versus Kyphoplasty:
A Comparison and Contrast . . . . 145 John M. Mathis, A. Orlando Ortiz,
and Gregg H. Zoarski
Chapter 10 Tumors . . . . 157 Hervé Deramond, Jacques Chiras, and Anne Cotten
Chapter 11 Extreme Vertebroplasty: Techniques for Treating
Difficult Lesions . . . . 185 John D. Barr and John M. Mathis
Chapter 12 Sacroplasty . . . . 197 Keith Kortman, John M. Mathis, and A. Orlando Ortiz
Chapter 13 Complications Associated with Vertebroplasty
and Kyphoplasty . . . . 210 John M. Mathis and Hervé Deramond
Chapter 14 Standards for the Performance of
Percutaneous Vertebroplasty: American College of Radiology and Society of Interventional
Radiology Guidelines . . . . 223
Section II Case Studies
Case 1 Single-Level Vertebroplasty and Biopsy . . . . 249 John M. Mathis
Case 2 Multilevel Vertebroplasty . . . . 255 James Ball and John M. Mathis
Case 3 Vertebra with a Cleft or Cavity . . . . 259 John M. Mathis
Case 4 The Mobile Vertebra: Height Restoration . . . . 263 John M. Mathis
Case 5 Extreme Vertebral Collapse . . . . 267 John M. Mathis
Case 6 Anterior Cervical Approach . . . . 272 John D. Barr and John M. Mathis
Case 7 Vertebral Refracture After Percutaneous
Vertebroplasty . . . . 277 Jon Kim and John M. Mathis
viii Contents
Case 8 Percutaneous Sacroplasty . . . . 281 John M. Mathis
Case 9 Percutaneous Pelvic Augmentation:
Supra-Acetabular Region . . . . 285 John M. Mathis
Case 10 Kyphoplasty in Osteoporotic Compression
Fractures . . . . 289 A. Orlando Ortiz and John M. Mathis
Case 11 Femoral Neck Augmentation . . . . 295 Paul F. Heini and Torsten Franz
Index . . . . 299
Contents ix
Contributors
xi
James Ball, MD, Chief of Neuroradiology, Department of Diagnostic
Radiology, Florida Hospital Medical Center, Orlando, FL, USA.
John D. Barr, MD, Chief, Interventional Neuroradiology, Department of Radiology, Baptist Memorial Hospital, Memphis, TN, USA.
Stephen M. Belkoff, PhD, Associate Professor, Director, Biomechanical Instrumentation Laboratory, Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, MD, USA.
Michele F. Bellantoni, MD, Associate Professor of Medicine, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Bronek Boszczyck, MD, Attending, Department of Orthopedic Surgery, University of Bern, Bern, Switzerland.
Jacques Chiras, MD, Professor, Department of Neuroradiology, Groupe Hospitalier Pitie-Salpetriere, Paris, France.
Anne Cotten, MD, Service de Radiologie Osteo-articulaire, Hôpital Roger Salengro, Centre Hospitalier Universitaire de Lille, Lille, France.
Aleksandar Curcin, MD, MBA, Spine Fellowship Director, Department of Orthopedic Surgery, Sinai Hospital of Baltimore, Baltimore, MD, USA.
Hervé Deramond, MD, Service d’imagerie médicale, Centre Hospitalier
Universitaire de Fort de France, Hopital Pierre Zobda-Quitman, Fort
de France, France.
Torsten Franz, MD, Attending, Department of Orthopedic Surgery, Uni- versity of Bern, Bern, Switzerland.
Paul F. Heini, PhD, MD, Head, Spine Surgery, Department of Orthope- dic Surgery, University of Bern, Bern, Switzerland.
Richard Henrys, MD, Spine Fellow, Department of Orthopedic Surgery, Sinai Hospital of Baltimore, Baltimore, MD, USA.
Jon Kim, MS, Third Year Medical Student, Virginia College of Osteo- pathic Medicine, Blacksburg, VA, USA.
Keith Kortman, MD, Neuroradiologist, Chief, Department of Radiology, Sharp Memorial Hospital, San Diego, CA, USA.
John M. Mathis, MD, MSc, Professor and Chairman, Department of Radiology, Virginia College of Osteopathic Medicine, Blacksburg, VA;
Medical Director, Centers for Advanced Imaging, Roanoke, VA, USA
René Orler, MD, Orthopädische Chirurgie, Universitätsspital Bern, Bern, Switzerland.
A. Orlando Ortiz, MD, MBA, Chairman, Department of Radiology, Winthrop-University Hospital; Professor, Department of Clinical Radi- ology, Stony Brook University School of Medicine, Mineola, NY, USA.
M.J.B. Stallmeyer, MD, PhD, Assistant Professor, Department of Radiol- ogy, University of Maryland School of Medicine, Baltimore, MD, USA.
Gregg H. Zoarski, MD, Director, Diagnostic and Interventional Neuro- radiology, Associate Professor, Department of Radiology, University of Maryland School of Medicine, Baltimore, MD, USA.
xii Contributors
