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Extra resources for Balloon Kyphoplasty
This requires a high ﬂow rate to ﬁll the vertebral body sufﬁciently and with this, a high injection pressure (Eq. IV). In addition, the injection pressure increases because of the increased cement viscosity. If the injection exceeds the forces a human being can apply, the injection will have to be aborted prematurely. Furthermore, the preferred goal is to have low injection pressures to reduce the extravasation risk as a result of the shear-thinning properties of the cement. The requirements of the injection process for uniform inﬁltration (high cement viscosity, low pressure) and for sufﬁcient ﬁlling of the vertebral bodies are thus exactly contrary.
Spine 8(8): 851–6 De Wijn JR (1976) Poly(methyl methacrylate)-aqueous phase blends: in situ curing porous materials. J Biomed Mater Res 10(4): 625–35 Dean JR, Ison KT, Gishen P (2000) The strengthening effect of percutaneous vertebroplasty. Clin Radiol 55(6): 471– 6 Fribourg D, Tang C, Sra P, Delamarter R, Bae H (2004) Incidence of subsequent vertebral fracture after kyphoplasty. Spine 29(20): 2270–76 Grados F, Depriester C, Cayrolle G, Hardy N, Deramond H, Fardellone P (2000) Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty.
However, biomechanical experiments have shown that this principle requires re-evaluation under certain circumstances, because the possible risk for an adjacent fracture has not been taken into consideration [Berlemann 2002]. Adjacent fractures are new compression fractures that occur in vertebrae adjacent to augmented vertebral bodies shortly after a vertebroplasty procedure. This phenomenon has been demonstrated in several clinical studies. Nevertheless, despite the risk of new vertebral compression fractures, one should not lose sight of the main effect of vertebroplasty, which is to improve the stability of the fractured vertebral body [Watts et al.