Percutaneous Vertebroplasty: A new injection technique minimizing cement leak

Introduction: Since introduction of vertebroplasty to clinical practice, the cement leak is considered the most frequent and hazardous complication. In literature, the cement extravasation ranged from 26-97% of the time. This study discussed a new technique for injecting cement in the affected vertebra. Methods: A hundred and twenty three patients were treated by vertebroplasty using the current technique. The package of the cement powder and the solvent was divided into five equal parts. Each part of the powder and the solvent was mixed as a single dose and injected to the affected vertebra. The duration between subsequent injections was 10 minutes. Each injection is formed of 1-1.5 ml. of cement. Results: This new technique gives the surgeon enough time to make multiple separate injections with the same package. The time interval between injections makes cement harden enough and makes it not pushed by the next cement injection. This technique of injection gives time to the injected cement to seal off the cracks and cavities in the vertebra and subsequently leads to a highly significant decreased in cement leak (Pleft perpendicular 0.001) compared to literature. Conclusions: This study demonstrates a previously unreported technique for vertebroplasty that adds more safety to the procedure by significantly decreasing cement leak. It also, gives the surgeon much more relaxation time and self-confidence during performing the procedure.