Elastoplasty as a promising novel technique: Vertebral augmentation with an elastic silicone-based polymer

Abstract

Objective: Percutaneous vertebroplasty with polymethylmethacrylate (PMMA) restores the stiffness andthe strength of fractured vertebral bodies, but changes the pattern of the stress transfer. This effect maycause a secondary fracture of the adjacent vertebrae. Elastoplasty has emerged as a new technique toovercome this complication. The aim of this study is to retrospectively evaluate the clinical results of theelastoplasty procedure.Materials and methods: Thirthy nine patients (9 males, 30 females, 87 spinal levels) were clinicallyevaluated pre and postoperatively in terms of pain relief, leakage and silicone embolism. The mean agewas 67 (range 38e84) years. The mean follow up period was 12,5 months. The patients were evaluatedradiologically for the presence of adjacent level fractures postoperatively. Complications were recorded.Results: The mean VAS score decreased from 7,5 to 3,5 during the last follow-up. Symptomatic siliconepulmonary embolism was not encountered in any patients. Leakage was observed in 5 (13%) cases. Therewas an adjacent level fracture in 1 case and another fracture which was not at the adjacent level inanother one. A hematoma occurred in the needle entry site in a patient with trombocytopenia (<70,000).Conclusions: Elastoplasty is a safe, promising technique in the treatment of vertebral compressionfractures (VCFs). Symptomatic silicone pulmonary embolism is not observed. The material's stiffness isclose to intact vertebrae. Therefore, elastoplasty may be a good viable option in the treatment of VCFs asit cause less complications and can prevent adjacent level fractures.Level of evidence: Level IV, therapeutic study.