Temperature Measurement During Polymerization of Bone Cement in Percutaneous Vertebroplasty: An In Vivo Study in Humans

被引:55
作者
Anselmetti, Giovanni Carlo [1 ]
Manca, Antonio [1 ,2 ]
Kanika, Khanna [3 ]
Murphy, Kieran [3 ]
Eminefendic, Haris [4 ]
Masala, Salvatore [5 ]
Regge, Daniele [4 ]
机构
[1] IRCC, Intervent Radiol Unit, I-10060 Turin, Italy
[2] Univ Sassari, I-07100 Sassari, Italy
[3] Johns Hopkins Univ Hosp, Baltimore, MD 21287 USA
[4] IRCC, Radiol Unit, I-10060 Turin, Italy
[5] Univ Roma Tor Vergata, Gen Hosp, Dept Diagnost Imaging Mol Imaging Intervent Radio, I-00133 Rome, Italy
关键词
Vertebroplasty; Bone cement; Temperature; Polymethylmethacrylate; Radiofrequency ablation; OSTEOPOROTIC COMPRESSION FRACTURES; VERTEBRAL BODY; POLYMETHYL-METHACRYLATE; PULMONARY-EMBOLISM; POLYMETHYLMETHACRYLATE; ABLATION; MANAGEMENT; ELEVATION; EFFICACY;
D O I
10.1007/s00270-009-9509-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim of the study was to "in vivo" measure temperature, during percutaneous vertebroplasty (PV), within a vertebral body injected with different bone cements. According to the declaration of Helsinki, 22 women (60-80 years; mean, 75 years) with painful osteoporotic vertebral collapse underwent bilateral transpedicular PV on 22 lumbar vertebrae. Two 10-G vertebroplasty needles were introduced into the vertebra under digital fluoroscopy; a 16-G radiofrequency thermoablation needle (Starburst XL; RITA Medical System Inc., USA), carrying five thermocouples, was than coaxially inserted. Eleven different bone cements were injected and temperatures were measured every 30 s until temperatures dropped under 45A degrees C. After the thermocouple needle was withdrawn, bilateral PV was completed with cement injection through the vertebroplasty needle. Unpaired Student's t-tests, Kruskal-Wallis test, and Wilcoxon signed rank test were used to evaluate significant differences (p < 0.05) in peak temperatures, variations between cements, and clinical outcome. All procedures were completed without complications, achieving good clinical outcomes (p < 0.0001). Regarding average peak temperature, cements were divided into three groups: A (over 60A degrees C), B (from 50A degrees to 60A degrees C), and C (below 50A degrees C). Peak temperature in Group A (86.7 +/- A 10.7A degrees C) was significantly higher (p = 0.0172) than that in Groups B (60.5 +/- A 3.7A degrees C) and C (44.8 +/- A 2.6A degrees C). The average of all thermocouples showed an extremely significant difference (p = 0.0002) between groups. None of the tested cements maintained a temperature a parts per thousand yen45A degrees C for more than 30 min. These data suggest that back-pain improvement is obtained not by thermal necrosis but by mechanical consolidation only. The relative necrotic thermal effect in vertebral metastases seems to confirm that analgesia must be considered the main intent of PV.
引用
收藏
页码:491 / 498
页数:8
相关论文
共 41 条
[11]   HYPERTHERMIA-INDUCED DAMAGE TO RAT SCIATIC-NERVE ASSESSED INVIVO WITH FUNCTIONAL METHODS AND WITH ELECTROPHYSIOLOGY [J].
DEVRIND, HH ;
WONDERGEM, J ;
HAVEMAN, J .
JOURNAL OF NEUROSCIENCE METHODS, 1992, 45 (03) :165-174
[12]   Management of acute osteoporotic vertebral fractures: A nonrandomized trial comparing percutaneous vertebroplasty with conservative therapy [J].
Diamond, TH ;
Champion, B ;
Clark, WA .
AMERICAN JOURNAL OF MEDICINE, 2003, 114 (04) :257-265
[13]   ASSESSMENT OF BONE VIABILITY AFTER HEAT TRAUMA - A HISTOLOGICAL, HISTOCHEMICAL AND VITAL MICROSCOPIC STUDY IN THE RABBIT [J].
ERIKSSON, RA ;
ALBREKTSSON, T ;
MAGNUSSON, B .
SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY, 1984, 18 (03) :261-268
[14]   Vertebral compression fractures: Pain reduction and improvement in functional mobility after percutaneous polymethylmethacrylate vertebroplasty-retrospective report of 245 cases [J].
Evans, AJ ;
Jensen, ME ;
Kip, KE ;
DeNardo, AJ ;
Lawler, GJ ;
Negin, GA ;
Remley, KB ;
Remley, KB ;
Boutin, SM ;
Dunnagan, SA .
RADIOLOGY, 2003, 226 (02) :366-372
[15]  
Fras Christian, 2003, Spine J, V3, P63, DOI 10.1016/S1529-9430(02)00455-2
[16]  
GALIBERT P, 1987, NEUROCHIRURGIE, V33, P166
[17]   Bone substitutes in vertebroplasty [J].
Heini, PF ;
Berlemann, U .
EUROPEAN SPINE JOURNAL, 2001, 10 (Suppl 2) :S205-S213
[18]  
LEESON MC, 1993, CLIN ORTHOP RELAT R, P239
[19]   Early-stage hepatocellular carcinoma in patients with cirrhosis: Long-term results of percutaneous image-guided radiofrequency ablation [J].
Lencioni, R ;
Cioni, D ;
Crocetti, L ;
Franchini, C ;
Della Pina, C ;
Lera, J ;
Bartolozzi, C .
RADIOLOGY, 2005, 234 (03) :961-967
[20]   Mechanical efficacy of vertebroplasty: Influence of cement type, BMD, fracture severity, and disc degeneration [J].
Luo, Jin ;
Skrzypiec, Daniel M. ;
Pollintine, Phillip ;
Adams, Michael A. ;
Annesley-Williams, Deborah J. ;
Dolan, Patricia .
BONE, 2007, 40 (04) :1110-1119