[Vertebroplasty: 10 years clinical and radiological follow-up]. / Vertébroplastie: évaluation clinique et radiologique à plus de dix ans.

OBJECTIVES: Ten years follow-up of the first patients treated with percutaneous vertebroplasty. PATIENT AND METHODS: Eighteen patients were retrospectively reviewed having undergone vertebroplasty in our centre between 1989 and 1998. Eight were treated for angioma, eight for osteoporotic compression and two followed for myeloma. They all underwent clinical and radiological evaluation in 2007 (standard X-rays, CT scan and MRI). These examinations were compared to prior baseline pre- and post-therapeutic images. RESULTS: Radiological characteristic of cement remained unchanged in the long term and there was no modification of anatomical structures in contact with it. Even if the distribution of cement was asymmetrical there was no fracture of the treated vertebras at distance. Degenerative changes of discs facing the vertebroplasty were not more pronounced than for distant discs. We found no significant signal or density anomaly of disc in contact direct with cement. 38.8 % of the patients presented new fractures (n=30). Seventy percent of the fractures were multiple and contiguous. In the long term, all patients reported improvement of pain after the procedure. CONCLUSION: In our series, we found a good stability of treatment over time. This study shows the long-term safety of percutaneous acrylic vertebroplasty, in particular harmlessness of cement for bone and discs in contact.

Balloon-related complications and technical failures in kyphoplasty for vertebral fractures.

BACKGROUND AND PURPOSE: Our aim was to describe the immediate or early complications and technical failures occurring during balloon kyphoplasty (BKP) procedures and attributable to balloon inflation. MATERIALS AND METHODS: We performed a retrospective review of all consecutive kyphoplasty procedures performed in our institution from May 2005 to October 2006. Fifty-one patients were treated by BKP at 75 spinal levels, and 137 vertebroplasties were performed as well. RESULTS: Several recurrent complications or procedural failures were observed during BKP: cortical or endplate fracture by balloon expansion (4 vertebrae), partial vertebral re-collapse after deflation (4 vertebrae), balloon rupture during inflation (5 vertebrae), and transient hyperalgia after the procedure (11 patients, 27.5%). CONCLUSIONS: Several symptomatic or asymptomatic complications and technical failures can occur during BKP. Some modifications of the usual kyphoplasty technique may decrease the frequency of these complications.