Johns Hopkins interventional radiologists have demonstrated that cement can be injected into the spine without prior, potentially dangerous dye studies.
Percutaneous vertebroplasty (PV), injecting cement into the spine to bolster it and relieve pain caused by tumors, compression fractures or other spinal damage, is usually done in tandem with venography, fluoroscopic imaging of the vertebral venous system using a contrast agent.
While venography helps clinicians identify potential sites of cement leakage into the vertebral venous system, it uses a contrast agent to improve imaging that can cause severe allergic reactions or pool in the treated area, making it more difficult for radiologists to monitor the cement injection.
According to a Hopkins study published in the June issue of the American Journal of Neuroradiology, however, venography prior to PV may not be necessary. The study team led by Kieran J. Murphy, M.D., director of interventional neuroradiology, found that in 205 consecutive PV procedures without venography, there were no major complications or cement leakage, showing PV can be performed in most cases without venography.
"Any time we can simplify a procedure and reduce the risk of complications without compromising the efficacy of the treatment, we have created a win-win situation," Murphy says. "Our results strongly suggest that percutaneous vertebroplasty can be performed safely without the need for this type of imaging."
In the study, the researchers performed 205 consecutive PVs in 137 patients without pretreatment venography. Patients were evaluated for complications linked to bone cement injection. No major complications were observed. The three minor complications that occurred were not linked to cement leakage.
More than 80 percent of the patients experienced major pain relief as a result of the procedure, according to Murphy.
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