Venospondylography as control and diagnostic method under the percutaneous vertebroplasty

Abstract

Venospondylography is a method, potentially capable to predict possible movement of bone cement during vertebroplasty out from the vertebral body. Leakage of bone cement into epidural venous plexuses can cause spinal cord and nerve roots compression. Leakage into paraspinal veins can lead to polymerization init and pulmonary embolism.48 patients during 2000-2006 have been operated by vertebroplasty on the thoracic and lumbar spine in cases of hemangiomas of vertebrae, metastatic tumors, osteoporotic and traumatic uncomplicated fractures of vertebrae 59 levels. At 48 patients vertebroplasty was made in 12 levels bilateral vertebroplasty was carried out. At 21 patients of I group before vertebroplasty venography studying was not performed (vertebroplasty was made at 26 levels). At 27 patients of II group before performing vertebroplasty the systemic venography was made (at all levels it was performed 33 venospondylography and was executed 33 vertebroplasty).It was noted, that in the second group it was appreciable below percent of complications. In the first group it was 26,9 %, in the second — 3 % of complications. The only case in which the venography was made and it was epidural spreading contrast was a case with a hemangioma of a body of a vertebra in which too liquid bone cement was used. There is case with serious complications in the first group where the additional operative procedures and time hospitalization was required.Venospondylography is an important diagnostic method, allowing to prognosticate an exit of bone cement in venous drainages of a vertebral body. Basing on data of venospondylography it is probable effectively to prevent an exit of bone cement out of vertebral body.