Substance that is used for veebroplasty is:
Correct Answer: Poly methyl methacrylate
Description: A i.e. Polymethyl methacrylate Veebroplast or kyphoplasty is percutaneous injection of bone cement (PMMA = polymethy methacrylate) into veebral bodyQ. It can be used for osteolytic spinal metastes, multiple myleoma, aggressive hemangiomas, osteoporotic veebral compression fractures. Its use has been recommended for patients with sho life expectancy or in salvage cases. It is contraindicated in infection eg TB, osteomyelitis, discitis etcQ. Veebroplasty & Kyphoplasty Veebroplasty is percutaneous placement of large spinal needles into the fractured / compressed veebral body through a channel made in the pedicle and injecting bone cement into th fractured bone. It requires high pressure injection b/o structure of the trabeculae and the high viscosity of the bone cement as it hardens. Veebroplasty was designed to decrease pain and strengthen the bone to prevent fuher collapse of a wedge compression fracture (that result from failure of anterior column by forward flexion forces). It does not restore veebral body height or prevent spinal deformity. Balloon Kyphoplasty is the next step in treatment of veebral compression fractures. This percutaneous minimally invasive procedure involves reduction & fixation performed through small instruments inseed into the veebral body through the pedicle. A small balloon is inflated to restore the height of collapsed veebral body and create a cavity inside. The balloon is deflated & withdrawn, and the remaining cavity is filled under low pressur with the surgeon's choice of material. This procedure restores veebral height & spinal alignment , which is impoant in preventing long term morbidity & moality that ariss from veebral compression fractures & spinal deformity (d/ t cardio-respiatory compromise) . It stabilities veebrae internally, facilitates pain relief and restores function rapidly. Polymethyl methacrylate (PMMA) bone cement is controlled injected in paste like consistency with fluoroscopic monitoring. 5g of barium sulfate and 2g of tungeston powder is mixed with each kit of PMMA cement to make it radiopaque enough to be visualized adqquately. Potential complications include extrusion of cement into the spinal canal, resulting in neurological compromise, infection, hematoma, pulmonary embolus, failure to relieve pain, and incomplete deformity correction. Pulmonary embolism was correlated with paraveebral venous cement leak, but not with the number of veebral bodies treated or the type of procedure (vetebroplasty or kyphoplasty). Indications Painful veebral metastasis, multiple myeloma (with or without adjuvant or surgery) Painful veebral hemangioma, osteonecosis Osteoporotic veebral compression fracturesQ >2 weeks old in cervical, thoracic and lumbar spine causing pain which is non responsive to medical management. Absolute Contraindications Infection eg tuberculosisQ, discitis, osteomyelitis, sepsis 2 weeks old in cervical, thoracic and lumbar spine causing pain which is non responsive to medical management. " v:shapes="_x0000_s1026">Untreated coagulopathy Osteoporotic veebral fracture which is completely healed or is clearly responding to medical management Relative Contraindications > 80-90% collapse of veebral body Significant compromise of spinal canal by retropulsed bone fragment or tumor >1 year old fracture
Category:
Surgery
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