Vertebroplasty Made Easy Arvind Bhave
INDEX
A
After percutaneous vertebroplasty 93
Anaesthesia 55
C
Cement leak 87
in the epidural space 87
in the foraminal region 86
in the spinal canal 86
in the veins 87
Cementing materials 19
Complications in vertebroplasty 81
Consequence of vertebral compression fractures 12
Contraindications for vertebroplasty 13
absolute 13
relative 13
D
Drapping and preparation 57
incision 60
point for infiltration for extrapedicular approach 59
E
European vertebral osteoporosis study group classification 32
I
Illustrative cases 97
Indications for vertebroplasty 12
absolute 12
relative 13
Interosseous venography 67
cement preparation 68
position of the needle 68
postoperative 71
venogram 68
Intervertebral pseudoarthrosis 38
avascular necrosis of vertebral body 38
K
Kyphoplasty 119
complications 122
contraindications 120
relative contraindication 120
indications 120
surgical steps 121
M
Most important five commandments to do vertebroplasty 74
Multilevel osteoporotic fractures 107
Multiple osteoporotic fractures 115
O
Osteoporotic vertebral compression fracture 5
conservative treatment 7
natural history 7
P
Paraparesis 93
Paraplegia 93
Patient evaluation and selection 16
clinical examination 16
CT scan 16
laboratory tests 16
MRI 16
X-rays 16
decompression theory 21
mechanical theory 20
thermal theory 21
Percutaneous vertebroplasty 2
PMMA cement related 82
Post vertebroplasty 114
Procedure of using the ‘AB needle for doing the vertebroplasty’—methods in transpedicular vertebroplasty 48
AB needle 48
advantages 48
monitoring 53
operating table 54
position of the patient 53
R
Review of literature 89
S
Surgical technique in vertebroplasty 47
T
T1 STIR T2 18
Tips and tricks: postural reduction 104
Tips to avoid the complications 84
V
Vertebra plana 113
Vertebral compression fractures 33
classification 33
biconcave deformity 34
crush 34
wedge compression 33
Vertebral fractures 23
anatomy 24
morphology 29
anterior wedging 30
codfish tail appearance 31
posterior wedging 32
site and units 32
whole body compression 31
Vertebral haemangioma 2
Vertebroplasty 2
development 2
history 2
Vertebroplasty in burst fractures 105
Vertebroplasty malignancies and bone tumours 45
Vertebroplasty—how does it work 20
Vesselplasty 127
concept 130
purpose 131
types of methods 128
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Chapter Notes

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1Vertebroplasty Made Easy®
2Vertebroplasty Made Easy®
Arvind Bhave MS (Ortho) IPTM (Israel) FICOE (USA) Fellow, Spinal Injuries Centre (Japan) Fellow, Minimally Invasive Spine Surgery (Korea) Spine Surgeon and Spine Endoscopist Bhave Hospital 48 Parvati Industrial Estate Pune Satara Road, Pune (India)
3Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
Corporate Office
4838/24 Ansari Road, Daryaganj, New Delhi 110 002, India, Phone: +91-11-43574357
Registered Office
B-3 EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi 110 002, India
Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021
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Branches
USA Office
1745, Pheasant Run Drive, Maryland Heights (Missouri), MO 63043, USA Ph: 001-636-6279734
Vertebroplasty Made Easy®
© 2008, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition: 2008
9788184484045
Typeset at JPBMP typesetting unit
Printed at Ajanta
4
To
Satguru Dada Maharaj, Swami Vivekanand, who always inspired me to do something for the mankind,
Usha mauli who has been lifelong guiding light,
All my family members who always supported me in my endeavor, and
All my students and well wishers who made me complete this small work
5Foreword
Vertebroplasty has been an exciting new technique to have gained popu-larity in the last decade. Its utility having been unquestionably estab-lished, technical innovations and variations have raised the bar for the precision and safety profile of this procedure.
As more and more indications get added to the conventional ones, con-ditions ranging from painful osteo-porotic fractures to vertebral metastasis are now being regularly managed by vertebroplasty.
The concerns of complications in an otherwise exacting procedure are more technique related, and the need is to overcome it by streamlining the procedure.
TheVertebroplasty Made Easy seems like the ideal refreshment for all spine surgeons to keep abreast with the ever expanding horizons of vertebroplasty.
Succinct and specific, it offers technical details, tips and tricks and an extensive literature review that sums up this useful manual.
It is a sincere effort by the author, Dr Arvind Bhave, at providing concise but detailed illustrative overview about the finer aspects of the procedure of vertebroplasty.
Wishing the book success in its endeavour.
Dr Shekhar Bhojraj
Consultant Spine Surgeon
Mumbai, India
6Preface
I am very happy to bring out the book Vertebroplasty Made Easy.
The book is intended for all those, who want to know more and develop the skills for vertebroplasty. This book will give insight into minimally invasive procedure of vertebroplasty.
The use of vertebroplasty in difficult situations has been shown in the chapter in few illustrative cases. It is also necessary to know about dangerous and fatal complications of this procedure and how to avoid them.
I take this opportunity to thank Shri JP Vij, Chairman and Managing Director and all the staff members of Jaypee Brothers Medical Publishers to publish the book on this novel procedure for enterprising doctors. I thank all my resident doctors, Dr Jainel Gandhi and colleagues who helped me to complete this book in short time.
I am very thankful to Dr Shekhar Bhojraj, Spine Surgeon, Mumbai, for encouraging me, to pursue spine surgery, to do something innovative and useful for the needy patients.
Arvind Bhave