Interventional Procedures of the Spine

A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (1 May 2019) | Viewed by 13350

Special Issue Editors


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Guest Editor
2nd Department of Radiology , Attikon University Hospital, National and Kapodistrian University of Athens , Greece
Interests: imaging; computed tomography; magnetic resonance; medical imaging; pain management; diagnostic radiology; diagnostic imaging; ultrasound imaging; hepatocellular carcinoma; ultrasonography; liver cancer imaging; interventional radiology; musculoskeletal imaging; spine; low back pain; back pain; neuroradiology; musculoskeletal sonography; elastography; spine research; rfa; intervertebral disk; interventional pain management; bone tumours; infiltration; ablation techniques; vertebroplasty; osteoid osteoma; osteoplasty
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Guest Editor
Department of Radiology II, Attikon University Hospital, Athens, Greece
Interests: musculoskeletal disorders; pain management; pain medicine; pain assessment; anaesthesiology; physiotherapy; radiology; pain measurement; pain perception; spine; low back pain; back pain; pain; scoliosis; intervertebral disk; local anesthetics; sciatica; intervertebral disc; needle biopsy

Special Issue Information

Dear Colleagues,

Interventional procedures of the spine include a wide array of techniques, which affect the intervertebral disc, the vertebral body, the posterior elements, as well as the relationship of those with the neural structures.
These techniques address various pathologies, including and not limited to vertebral fractures (osteoporotic, traumatic and malignant), disc herniation, spinal stenosis, discoradicular conflict, facet and sacroiliac joint pain. They interest a wide variety of doctors (spine surgeons, neurosurgeons, anaesthesiologists, interventional radiologists etc).

The purpose of such a special issue is to show the presence of therapies other than conservative treatment or surgery, which can be performed under imaging guidance with minimal hospital stay. These techniques can serve as attractive alternatives to surgical options, resulting in pain reduction and mobility improvement, with a clear effect on quality of life.

We remain at your disposal for additional questions.

Prof. Dr. Alexis Kelekis
Prof. Dr. Dimitris Filippiadis
Guest Editors

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Keywords

  • Spine
  • Pain
  • Percutaneous treatment
  • Imaging guidance

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Published Papers (3 papers)

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Research

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9 pages, 1551 KiB  
Article
Mechanical Cavity Creation with Curettage and Vacuum Suction (Q-VAC) in Lytic Vertebral Body Lesions with Posterior Wall Dehiscence and Epidural Mass before Cement Augmentation
by Eike I. Piechowiak, Maurizio Isalberti, Marco Pileggi, Daniela Distefano, Joshua A. Hirsch and Alessandro Cianfoni
Medicina 2019, 55(10), 633; https://doi.org/10.3390/medicina55100633 - 24 Sep 2019
Cited by 5 | Viewed by 2992
Abstract
Background and Objectives: We describe a novel technique for percutaneous tumor debulking and cavity creation in patients with extensive lytic lesions of the vertebral body including posterior wall dehiscence prior to vertebral augmentation (VA) procedures. The mechanical cavity is created with a combination [...] Read more.
Background and Objectives: We describe a novel technique for percutaneous tumor debulking and cavity creation in patients with extensive lytic lesions of the vertebral body including posterior wall dehiscence prior to vertebral augmentation (VA) procedures. The mechanical cavity is created with a combination of curettage and vacuum suction (Q-VAC). Balloon kyphoplasty and vertebral body stenting are used to treat neoplastic vertebral lesions and might reduce the rate of cement leakage, especially in presence of posterior wall dehiscence. However, these techniques could theoretically lead to increased intravertebral pressure during balloon inflation with possible mobilization of soft tissue tumor through the posterior wall, aggravation of spinal stenosis, and resultant complications. Creation of a void or cavity prior to balloon expansion and/or cement injection would potentially reduce these risks. Materials and Methods: A curette is coaxially inserted in the vertebral body via transpedicular access trocars. The intravertebral neoplastic soft tissue is fragmented by multiple rotational and translational movements. Subsequently, vacuum aspiration is applied via one of two 10 G cannulas that had been introduced directly into the fragmented lesion, while saline is passively flushed via the contralateral cannula, with lavage of the fragmented solid and fluid-necrotic tumor parts. Results: We applied the Q-VAC technique to 35 cases of thoracic and lumbar extreme osteolysis with epidural mass before vertebral body stenting (VBS) cement augmentation. We observed extravertebral cement leakage on postoperative CT in 34% of cases, but with no clinical consequences. No patients experienced periprocedural respiratory problems or new or worsening neurological deficit. Conclusion: The Q-VAC technique, combining mechanical curettage and vacuum suction, is a safe, inexpensive, and reliable method for percutaneous intravertebral tumor debulking and cavitation prior to VA. We propose the Q-VAC technique for cases with extensive neoplastic osteolysis, especially if cortical boundaries of the posterior wall are dehiscent and an epidural soft tissue mass is present. Full article
(This article belongs to the Special Issue Interventional Procedures of the Spine)
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Review

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9 pages, 1403 KiB  
Review
Innovative Spine Implants for Improved Augmentation and Stability in Neoplastic Vertebral Compression Fracture
by Francois H. Cornelis, Quentin Joly, Maud Nouri-Neuville, Mohamed Ben-Ammar, Bruno Kastler, Adrian Kastler, Nicolas Amoretti and Olivier Hauger
Medicina 2019, 55(8), 426; https://doi.org/10.3390/medicina55080426 - 31 Jul 2019
Cited by 20 | Viewed by 5414
Abstract
Background and objectives: Tumor-related vertebral compression fractures often result in severe back pain as well as progressive neurologic impairment and additional morbidities. The fixation of these fractures is essential to obtain good pain relief and to improve the patients’ quality of life. Thus [...] Read more.
Background and objectives: Tumor-related vertebral compression fractures often result in severe back pain as well as progressive neurologic impairment and additional morbidities. The fixation of these fractures is essential to obtain good pain relief and to improve the patients’ quality of life. Thus far, several spine implants have been developed and studied. The aims of this review were to describe the implants and the techniques proposed to treat cancer-related vertebral compression fractures and to compile their safety and efficacy results. Materials and Methods: A systematic MEDLINE/PubMed literature search was performed, time period included articles published between January 2000 and March 2019. Original articles were selected based on their clinical relevance. Results: Four studies of interest and other cited references were analyzed. These studies reported significant pain and function improvement as well as kyphotic angle and vertebral height restoration and maintain for every implant and technique investigated. Conclusions: Although good clinical performance is reported on these devices, the small numbers of studies and patients investigated draw the need for further larger evaluation before drawing a definitive treatment decision tree to guide physicians managing patients presenting with neoplastic vertebral compression fracture. Full article
(This article belongs to the Special Issue Interventional Procedures of the Spine)
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9 pages, 3053 KiB  
Review
Percutaneous Interspinous Spacer in Spinal-Canal-Stenosis Treatment: Pros and Cons
by Chiara Zini, Matteo Bellini, Salvatore Masala and Stefano Marcia
Medicina 2019, 55(7), 381; https://doi.org/10.3390/medicina55070381 - 16 Jul 2019
Cited by 9 | Viewed by 4377
Abstract
A comprehensive description of the literature regarding interspinous process devices (IPD) mainly focused on comparison with conservative treatment and surgical decompression for the treatment of degenerative lumbar spinal stenosis. Recent meta-analysis and articles are listed in the present article in order to establish [...] Read more.
A comprehensive description of the literature regarding interspinous process devices (IPD) mainly focused on comparison with conservative treatment and surgical decompression for the treatment of degenerative lumbar spinal stenosis. Recent meta-analysis and articles are listed in the present article in order to establish IPD pros and cons. Full article
(This article belongs to the Special Issue Interventional Procedures of the Spine)
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