• Journal of the Korean Society of Radiology
• /
• v.11 no.2
• /
• pp.139-144
• /
• 2017

Percutaneous vertebroplasty (PVP) is increasingly used to treat osteoporotic vertebral fractures, myeloma and osteolytic vertebral metastases. The purpose of this study was to measure the absorbed radiation exposure dose and time during PVP and to assess the possibility of deterministic radiation effects to the operator and patient. The radiation dose and time measure by three pain physicians performed consecutive procedures using the twenty case PVP. Patient's dosimeter placed at the anteroposterior(AP) side was treatment of the vertebra body located in the upper level 2-3 and lateral(LAT) side was flank proximal to C-arm tube of back. Operator's dosimeter placed at the apron outside of upper sternum (thyroid), left chest, lower extremity and apron inside of left chest. Results: Radiation exposure times were $3.6{\pm}0.71min$. Measurements on the Patient radiation dose were AP $121.4{\pm}48.1{\mu}Sv$, LAT side $614.7{\pm}177.1{\mu}Sv$. Operator radiation dose were outside of the lead apron upper sternum $33.7{\pm}7.3{\mu}Sv$, outside of the lead apron chest $49.2{\pm}15.0{\mu}Sv$, outside of the lead apron lower extremity $12.8{\pm}3.8{\mu}Sv$ and inside of the lead apron chest $4.2{\pm}1.4{\mu}Sv$. To escape from the danger of radiation first long distance from the c-arm tube second exposure time reduced second lead apron used fluoroscopy during PVP is more safety patient and operation from the radiation exposure.

• Journal of the Korean Orthopaedic Association
• /
• v.54 no.1
• /
• pp.24-29
• /
• 2019

Purpose: To evaluate the characteristics and the risk factors of early onset subsequent vertebral compression fractures after percutaneous vertebroplasty. Materials and Methods: A total of 44 patients, who had a new subsequent vertebral fracture after percutaneous vertebroplasty for an osteoporotic vertebral compression fracture between January 2013 and December 2015, were recruited. The patients were divided into two groups according to the onset period of subsequent fracture. The number of patients who had a fracture within 3 months following vertebroplasty were 22 cases (Group A); after 3 months were 22 cases (Group B). Variables, including age, sex, bone mineral density (BMD), body mass index (BMI), preexisting vertebral compression fracture, location of the initial fracture, intradiscal cement leakage, injected cement volume, restoration of vertebral body height, and correction of kyphosis, in the two groups were analyzed and compared retrospectively. Results: The age, sex, BMD, BMI, preexisting vertebral compression fracture, location of the initial fracture, intradiscal cement leakage, and correction of kyphosis were similar in the two groups. Both a greater volume of bone cement injected and a greater degree of vertebral height restoration contributed significantly to the risk of fracture within 3 months. Conclusion: The cement volume and degree of height restoration are risk factors for early onset fracture at the adjacent vertebrae after percutaneous vertebroplasty and close attention is needed during the follow-up period.

• Journal of the Korean Orthopaedic Association
• /
• v.54 no.5
• /
• pp.435-439
• /
• 2019

Purpose: This study evaluated the efficacy of blood mixed cement for osteoporotic vertebral compression fractures in reducing the complications of percutaneous vertebroplasty using conventional cement. Materials and Methods: This study was performed retrospectively in 80 patients, from January 2016 to January 2017. Porous cement was formed by mixing 2, 4, and 6 ml of blood with 20 g of cement used previously. A tube with a diameter and length of 2.8 mm and 215 mm, respectively, was used and the polymerization temperature, setting time, and optimal passing-time were measured and compared with those using only conventional cement. Radiologically, the results were evaluated and compared. Results: The polymerization temperature was 70.3℃, 55.3℃, 52.7℃, and 45.5℃ in the conventional cement (R), 2 ml (B2), 4 ml (B4), and 6 ml (B6), respectively, and the corresponding setting time decreased from 960 seconds (R) to 558 seconds (B2), 533 seconds (B4), and 500 seconds (B6). The optimal passing-time was 45 seconds (B2), 60 seconds (B4), and 78 seconds (B6) at 73 seconds (R), respectively and as the amount of blood increased, it was similar to the cement passing-time. The radiological results showed that the height restoration rates and the vertebral subsidence rates similar among the groups. Two cases of adjacent vertebral compression fractures in the R group and one in the B2 and B4 groups were encountered, and the leakage rate of the cement was approximately two times higher than that in the conventional cement group. Conclusion: In conventional percutaneous vertebroplasty, the procedure of using autologous blood with cement decreased the polymerization temperature, reduced the setting time, and the incidence of cement leakage was low. These properties may contribute to more favorable mechanical properties that can reduce the complications compared to conventional cements alone.

• The Korean Journal of Pain
• /
• v.13 no.1
• /
• pp.126-129
• /
• 2000

Age-related osteoporotic compression fractures occur frequently in old aged group recently. Percutaneous vertebroplasty has recently been introduced as a therapeutic method for the treatment of pain associated with osteoporotic vertebral compression fracture. Percutaneous intravertebral injection of PMMA (polymethylmethacrylate) results in marked reduction in pain and morbidity. Among complications during vertebroplasty with PMMA, pulmonary embolism is repotred occasionally but the reports about hypotension are not common. This case is a report of a patient whom significant hypotension occured during percutaneous vertebroplasty.