Kummel disease treatment by unipedicular vertebral augmentation using curved injection cannula

Cardiovasc Intervent Radiol. 2011 Oct;34(5):1014-20. doi: 10.1007/s00270-010-9985-9. Epub 2010 Sep 22.

Abstract

Purpose: This study was designed to evaluate the efficacy of the blunt-tipped curved injection needle (BCN) AVAflex (Care Fusion) for vertebral augmentation in cases of Kummel's disease.

Methods: We performed 25 vertebral augmentation procedures on 25 consecutive patients (11 men/14 women; mean age, 67 years) with Kummel's disease using the blunt-tipped curved injection needle with PMMA cement. We performed all 25 procedures by unipedicular left approach with patients in prone position under local anesthesia and mild sedation. In all cases, an intravertebral cleft was evident on preprocedural imaging. We evaluated pain intensities by Visual Analogic Scale (VAS) before and at first day, 6 months, and 1 year after procedure.

Results: In all cases the curved injection cannula permitted the filling of the clefts and surrounding cancellous bone without any complication. A significant reduction of kyphotic deformities of the treated vertebral bodies was evident. A significance decrease in VAS values at 1 year also was evident (mean decrease 7.2). At plain dynamic postprocedural X-rays checks, there was no sign of pathologic intravertebral motion as evidence of optimal stabilization.

Conclusions: BCN AVAflex is a safe and effective device for targeted vertebral augmentation in cases of Kummel's disease. Its distinctive characteristic is the curved injection cannula, which enables targeting the cement injection to areas far off the trajectory of the straight access cannula, thus providing excellent cement spread throughout the entire volume of vertebral body.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Cements / therapeutic use*
  • Female
  • Fractures, Compression / complications
  • Fractures, Compression / therapy*
  • Humans
  • Injections / instrumentation
  • Kyphosis / etiology
  • Kyphosis / therapy*
  • Male
  • Middle Aged
  • Needles
  • Osteonecrosis / etiology
  • Osteoporotic Fractures / complications
  • Osteoporotic Fractures / therapy*
  • Pain Measurement
  • Polymethyl Methacrylate / administration & dosage*
  • Spinal Diseases / etiology
  • Spinal Diseases / therapy*
  • Spinal Fractures / complications
  • Spinal Fractures / therapy*

Substances

  • Bone Cements
  • Polymethyl Methacrylate