Chinese Journal of Tissue Engineering Research ›› 2010, Vol. 14 ›› Issue (51): 9683-9686.doi: 10.3969/j.issn.1673-8225.2010.51.043

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Treatment of noninfected avascular necrosis of the vertebral body using polymethyl methacrylate bone cement with percutaneous vertebroplasty

Yang Sheng1, Lu Jian-min1, Zhao De-wei1, Zhou Dan-yang2, Li Xin-lu1   

  1. 1 Department of Orthopaedics, 2 CT Room, Affiliated Zhongshan Hospital of Dalian University, Dalian   116001, Liaoning Province, China
  • Online:2010-12-17 Published:2010-12-17
  • About author:Yang Sheng☆ Doctor, Associate chief physician, Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, Liaoning Province, China gzsyang@yahoo.com.cn
  • Supported by:

    the National Natural Science Foundation of China, No. 30870647*

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Abstract:

BACKGROUND: Noninfected avascular necrosis of the vertebral body (NAVN) is not common, usually manifestated with compression fracture of vertebral body. There are few reports regarding it in China, due to insufficient understanding and low incidence.
OBJECTIVE: To evaluate the characteristics of NAVN and the efficacy of percutaneous vertebroplasty (PVP) in the treatment of NAVN.
METHODS: A retrospective clinical study on the effect of PVP in the treatment of 12 NAVN cases in recent five years was performed. Under the guidance of digital subtraction angiography, vertebral bodies were injected polymethyl methacrylate bone cement through the vertebral pedicle. The pain level of each patient was assessed, both before and after the procedure, using a visual analogue scale. The heights of anterior border and central vertebral bodies were measured before and after PVP in a lateral projection.
RESULTS AND CONCLUSION: Twelve vertebral bodies of NAVN were successfully treated with PVP, and PMMA injected into each vertebral body was average (6.0±1.5) mL. Complete relief or obvious relief was obtained in 10 cases (83%), moderate relief was got in 2 cases (17%). Visual analogue scale score decreased from 9.08±0.76 before operation to 2.33±1.43 at 3 days after PVP, and 1.08±0.95 at 6 months after PVP (P < 0.01). The mean increase in vertebral body height at 3 days was 2.2 mm anteriorly and 2.3 mm centrally. PVP combined with polymethyl methacrylate injection is proved to be an effective procedure for the treatment of NAVN, it could provide quick pain relief and partially restore the height of compressed vertebral body.

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