Percutaneous consolidation of loosened spine arthrodesis under CT and fluoroscopy guidance by radiologists: a new useful technique

Objective The objective was to evaluate percutaneous computed tomography (CT) and fluoroscopy-guided injection of bone cement for consolidation of loosened posterior arthrodesis performed by radiologists. Methods A single-centre prospective study involving four consecutive patients (three women, one...

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Veröffentlicht in:European radiology 2015-04, Vol.25 (4), p.1135-1139
Hauptverfasser: Amoretti, Nicolas, Bertrand, Anne-Sophie, Gallo, Giacomo, Caudal, Amandine, Cornelis, Francois, Hauger, Olivier, Boileau, Pascal
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container_issue 4
container_start_page 1135
container_title European radiology
container_volume 25
creator Amoretti, Nicolas
Bertrand, Anne-Sophie
Gallo, Giacomo
Caudal, Amandine
Cornelis, Francois
Hauger, Olivier
Boileau, Pascal
description Objective The objective was to evaluate percutaneous computed tomography (CT) and fluoroscopy-guided injection of bone cement for consolidation of loosened posterior arthrodesis performed by radiologists. Methods A single-centre prospective study involving four consecutive patients (three women, one man) suffering from screw loosening (three at the vertebral level, one at the iliac wing level) after Posterior Lumbar Interbody Fusion (PLIF) treatment was done. The average age was 80 years. Surgical treatment was not indicated or not wished for by the patients. Institutional review board approval and informed consent were obtained. Percutaneous consolidation was performed by an interventional radiologist under CT and fluoroscopy guidance. The path of the trocars was made outside loosened screws bilaterally. Follow-up was assessed using the Visual Analog Scale (VAS). Results In all cases, bone cement was successfully placed around the loosened screw. The mean volume of cement that was injected was 3 ml. No cement leakage was observed. No neurological complication occurred. Using VAS, pain decreased from more than 9/10 preoperatively to less than 2/10 the day after the procedure for all patients ( p  
doi_str_mv 10.1007/s00330-014-3475-4
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Methods A single-centre prospective study involving four consecutive patients (three women, one man) suffering from screw loosening (three at the vertebral level, one at the iliac wing level) after Posterior Lumbar Interbody Fusion (PLIF) treatment was done. The average age was 80 years. Surgical treatment was not indicated or not wished for by the patients. Institutional review board approval and informed consent were obtained. Percutaneous consolidation was performed by an interventional radiologist under CT and fluoroscopy guidance. The path of the trocars was made outside loosened screws bilaterally. Follow-up was assessed using the Visual Analog Scale (VAS). Results In all cases, bone cement was successfully placed around the loosened screw. The mean volume of cement that was injected was 3 ml. No cement leakage was observed. No neurological complication occurred. Using VAS, pain decreased from more than 9/10 preoperatively to less than 2/10 the day after the procedure for all patients ( p  &lt; 0.05). Conclusion This study suggests that loosening of spine arthrodesis could be successfully treated by percutaneous injection of bone cement under CT and fluoroscopy guidance. Key Points • PLIF is one of the surgical techniques for spinal arthrodesis. • Treatment indications are degenerative disease or instability following trauma, tumour, or infection. • Screw loosening is a frequent complication that can occur after surgery. • Percutaneous facet consolidation under dual guidance seems to be a feasible technique. • The procedure is performed under local anaesthesia using a minimally invasive approach.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-014-3475-4</identifier><identifier>PMID: 25358596</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Aged, 80 and over ; Anesthesia, Local ; Animals ; Arthrodesis ; Bone Cements - therapeutic use ; Diagnostic Radiology ; Female ; Fluoroscopy ; Fractures ; Humans ; Imaging ; Internal Medicine ; Interventional Radiology ; Lumbosacral Region - diagnostic imaging ; Male ; Medicine ; Medicine &amp; Public Health ; Neuroradiology ; Pain ; Pain Measurement ; Polymethyl methacrylate ; Prospective Studies ; Radiology ; Radiology, Interventional ; Review boards ; Scintigraphy ; Spinal Fusion - methods ; Tomography ; Tomography, X-Ray Computed ; Treatment Outcome ; Ultrasound ; Vascular-Interventional ; Vertebrae</subject><ispartof>European radiology, 2015-04, Vol.25 (4), p.1135-1139</ispartof><rights>European Society of Radiology 2014</rights><rights>European Society of Radiology 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-30ac03d7f15962dbff1d36b8a8e54b05b8f33220fe1b0fd48f3eba03c06f7bb23</citedby><cites>FETCH-LOGICAL-c372t-30ac03d7f15962dbff1d36b8a8e54b05b8f33220fe1b0fd48f3eba03c06f7bb23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-014-3475-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-014-3475-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25358596$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Amoretti, Nicolas</creatorcontrib><creatorcontrib>Bertrand, Anne-Sophie</creatorcontrib><creatorcontrib>Gallo, Giacomo</creatorcontrib><creatorcontrib>Caudal, Amandine</creatorcontrib><creatorcontrib>Cornelis, Francois</creatorcontrib><creatorcontrib>Hauger, Olivier</creatorcontrib><creatorcontrib>Boileau, Pascal</creatorcontrib><title>Percutaneous consolidation of loosened spine arthrodesis under CT and fluoroscopy guidance by radiologists: a new useful technique</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objective The objective was to evaluate percutaneous computed tomography (CT) and fluoroscopy-guided injection of bone cement for consolidation of loosened posterior arthrodesis performed by radiologists. Methods A single-centre prospective study involving four consecutive patients (three women, one man) suffering from screw loosening (three at the vertebral level, one at the iliac wing level) after Posterior Lumbar Interbody Fusion (PLIF) treatment was done. The average age was 80 years. Surgical treatment was not indicated or not wished for by the patients. Institutional review board approval and informed consent were obtained. Percutaneous consolidation was performed by an interventional radiologist under CT and fluoroscopy guidance. The path of the trocars was made outside loosened screws bilaterally. Follow-up was assessed using the Visual Analog Scale (VAS). Results In all cases, bone cement was successfully placed around the loosened screw. The mean volume of cement that was injected was 3 ml. No cement leakage was observed. No neurological complication occurred. Using VAS, pain decreased from more than 9/10 preoperatively to less than 2/10 the day after the procedure for all patients ( p  &lt; 0.05). Conclusion This study suggests that loosening of spine arthrodesis could be successfully treated by percutaneous injection of bone cement under CT and fluoroscopy guidance. Key Points • PLIF is one of the surgical techniques for spinal arthrodesis. • Treatment indications are degenerative disease or instability following trauma, tumour, or infection. • Screw loosening is a frequent complication that can occur after surgery. • Percutaneous facet consolidation under dual guidance seems to be a feasible technique. • The procedure is performed under local anaesthesia using a minimally invasive approach.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthesia, Local</subject><subject>Animals</subject><subject>Arthrodesis</subject><subject>Bone Cements - therapeutic use</subject><subject>Diagnostic Radiology</subject><subject>Female</subject><subject>Fluoroscopy</subject><subject>Fractures</subject><subject>Humans</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Lumbosacral Region - diagnostic imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine &amp; 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Methods A single-centre prospective study involving four consecutive patients (three women, one man) suffering from screw loosening (three at the vertebral level, one at the iliac wing level) after Posterior Lumbar Interbody Fusion (PLIF) treatment was done. The average age was 80 years. Surgical treatment was not indicated or not wished for by the patients. Institutional review board approval and informed consent were obtained. Percutaneous consolidation was performed by an interventional radiologist under CT and fluoroscopy guidance. The path of the trocars was made outside loosened screws bilaterally. Follow-up was assessed using the Visual Analog Scale (VAS). Results In all cases, bone cement was successfully placed around the loosened screw. The mean volume of cement that was injected was 3 ml. No cement leakage was observed. No neurological complication occurred. Using VAS, pain decreased from more than 9/10 preoperatively to less than 2/10 the day after the procedure for all patients ( p  &lt; 0.05). Conclusion This study suggests that loosening of spine arthrodesis could be successfully treated by percutaneous injection of bone cement under CT and fluoroscopy guidance. Key Points • PLIF is one of the surgical techniques for spinal arthrodesis. • Treatment indications are degenerative disease or instability following trauma, tumour, or infection. • Screw loosening is a frequent complication that can occur after surgery. • Percutaneous facet consolidation under dual guidance seems to be a feasible technique. • The procedure is performed under local anaesthesia using a minimally invasive approach.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>25358596</pmid><doi>10.1007/s00330-014-3475-4</doi><tpages>5</tpages></addata></record>
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source MEDLINE; SpringerLink Journals - AutoHoldings
subjects Aged
Aged, 80 and over
Anesthesia, Local
Animals
Arthrodesis
Bone Cements - therapeutic use
Diagnostic Radiology
Female
Fluoroscopy
Fractures
Humans
Imaging
Internal Medicine
Interventional Radiology
Lumbosacral Region - diagnostic imaging
Male
Medicine
Medicine & Public Health
Neuroradiology
Pain
Pain Measurement
Polymethyl methacrylate
Prospective Studies
Radiology
Radiology, Interventional
Review boards
Scintigraphy
Spinal Fusion - methods
Tomography
Tomography, X-Ray Computed
Treatment Outcome
Ultrasound
Vascular-Interventional
Vertebrae
title Percutaneous consolidation of loosened spine arthrodesis under CT and fluoroscopy guidance by radiologists: a new useful technique
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