Intraoperative PEEP-ventilation during PMMA-injection for augmented pedicle screws: improvement of leakage rate in spinal surgery

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
A El SamanH Laurer

Abstract

Within the last two decades the use of polymethylmethacrylate (PMMA) in the treatment of osteoporotic vertebral fractures has been established widely. Several techniques of cement application in spinal surgery have been described. Besides classical vertebroplasty, kyphoplasty and related techniques that reinforce stability of the fractured vertebral body itself, augmentation of pedicle screws became an issue in the past 10 years. Aim of this technique is strengthening of the implant-bone-interface and the prevention of loosening and failure of posterior instrumentation in limited bone quality due to osteoporosis. PMMA use in spinal surgery always bears the risk of cement leakage and cement embolism. There are only few publications dealing with cement leakage in pedicle screw augmentation. We examined our cohort concerning incidence and type of leakage in comparison to the literature. In particular, we evaluated a possible role of intrathoracic pressure during cementation procedure. In this retrospective study 42 patients were included. Mean age was 74 (57-89) years. 311 fenestrated, augmented screws were analyzed postoperatively concerning leakage and subsequent pulmonary embolism of cement particles. Overall, there was a leaka...Continue Reading

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Citations

Oct 1, 2013·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·H Laurer, I Marzi
Nov 16, 2018·Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy·Yann CroissantChristoph Czerny
May 2, 2018·Asian Spine Journal·Jose Manuel Fernando Ignacio, Katrina Hannah Dizon Ignacio
Mar 4, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·André El SamanIngo Marzi
Jul 3, 2020·Der Unfallchirurg·Klaus John SchnakeUNKNOWN Arbeitsgruppe Osteoporotische Frakturen der Sektion Wirbelsäule
Apr 29, 2019·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Hui-Zhi GuoXiao-Bing Jiang

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