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COVID-19 Fatigue May be More Prevalent in Diabetic Patients

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What Are They Recommending Today That's "Good" For Us?

What Are They Recommending Today That’s “Good” For Us?

And why do you, and others, believe them?

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[questionharsha-blog]

What Is The Most Common Indication For Percutaneous Vertebroplasty?

Percutaneous Vertebroplasty, also known as vertebral packing or vertebroplasty, is a procedure in which a medical grade cement is injected through a needle into a painful, fractured vertebral body. The procedure is aimed at preventing vertebral body collapse and pain in patients with bone failure. The procedure originated in the year 1984 has become popular, and many technical improvements have been made since then.

Indications

Severe painful osteoporosis with loss of height or compression fractures of vertebral bodies.

Painful compression fractures in patients with osteoporosis refractory to conservative therapy.

The ideal candidate for vertebroplasty presents within four months of fracture and has midline, nonradiating back pain that increases with weight-bearing and can be exacerbated by manual palpation of the spinous process of the involved vertebra.

Symptomatic vertebral angioma.

Painful vertebral body tumors and acetabular tumors.

In cancer patients, the technique is used mainly in the symptomatic treatment of osteolytic bone metastases and myeloma. As vertebroplasty is intended only to relieve pain weight-bearing bone, other specific tumor therapy should be given in conjunction.

The use of PMMA is reserved for the weight-bearing bone. In other locations, alcohol or other pain thermoablation techniques can be used to treat the pain.

Contraindications

Hemorrhagic diathesis

Infection

Lesions with epidural extension. These require a careful injection to prevent epidural overflow and spinal cord compression by the cement or displaced epidural tissue.

Patients with more than five or diffuse metastases

Overview of the procedure

The procedure is performed under local anesthesia combined with neuroleptanalgesia. The patient is placed in a prone position for lumbar and thoracic levels and supine position for cervical levels.

A 15-gauge needle is used for cervical vertebrae and a 10-gauge needle for thoracic and lumbar vertebrae. A dual-guidance CT and C-arm fluoroscopy or biplane fluoroscopy is used.

CT is used to determine the entry point and the pathway, avoiding the nerve root and visceral structures. The needle is safely guided under CT or biplane fluoroscopy.

The imaging mode is switched to fluoroscopy once the needle is held in the optimal position.

The acrylic cement mixed with tantalum (to increase radiopacity) is injected during the pasty polymerization phase to prevent distal venous migration.

The injection of cement is carefully controlled under strict lateral fluoroscopy. The injection is stopped when epidural or paravertebral opacification is observed or when the cement reaches the dorsal quarter of the vertebral body.

Complications

Cement leak is the most severe and frequent complication.

The second most serious complication is an infection.

Temporary pain might occur after the procedure.

Allergic reactions and hypertension are limited in these procedures as the quantity of cement injected in this procedure are far less than that used in orthopedic surgery.

Read more https://wcts.app/Vertebroplasty