Introduction: Due to its minimal invasion and immediate pain relief ballon kyphoplasty has gained an increased popularity for treatment of symptomatic tumor or osteoporotic vertebral fractures. Kyphoplasty in cancer patients is more challenging than for osteoporotic ones. Cord compression is frequent and the incidence of overall complications is ten-fold greater. Polimethylmethylacrylate (PMMA) cement is considered the gold standard material for such procedures. Although success rate is high, PMMA has also limitations and safety concerns: exothermic reaction, short working time (5 minutes), rapid solidification, it is not adhesive to bone, leakages are dangerous.
Methods: VK100 is a mixture of Dimethyl methylvinyl siloxane, Barium Sulphate, Platinum catalysat, and methylhydrogensiloxane cross linker. Polymerisation occurs after mixture. Surgical procedure is the standard kyphoplasty. VK100 adheres to bone, has no exothermic reaction, leaves up to 15 minutes before definitive solidification, is more elastic. The base material has been used in humans for 30 years. Between February 2013 and January 2015 we treated 58 patients (48 with cancer disease and 10 with osteoporosis) and 96 vertebral bodies (53 thoracic, 43 lumbar): 65 through percutaneous kyphoplasty, 23 “open kyphoplasty” with laminectomy; “augmentation vertebroplasty” in major open surgery was done in 7 to implement stabilization.
Results: Follow-up ranged between 24 and 2 months. Complications included two asymptomatic pulmonary embolism, five leakages (intradiscal, endospecal, vascular), two motor deficits requiring in one, surgical revision, three adjacent fractures. QOL as measured by VAS and VS-36 scales improved in all cases by 50 to 70%. Average working time was more than 15 minutes.
Conclusions: This technique seems to be safer than that with PMMA and particularly suited for pathologic vertebral fractures. Leakages may have less severe outcome either for the non-exothermic reaction, or as this material has not the space occupying effect of PMMA. Further studies are needed to confirm these results.
Patient Care: VK100 purified silicone may potentially be more efficient and offer less risks to patients operated with vertebroplasty/kyphoplasty for vertebral compression fractures
Learning Objectives: By the conclusion of this sessions, participants should be able to describe the different surgical techniques in which silicone VK100 and PMMA are employed to deal with vertebral compression fractures and identify the difference between these materials.