North American Spine Society Newly Released Vertebroplasty RCTs: A Tale of Two Trials

On August 6, 2009, the New England Journal of Medicine published two randomized controlled trials on vertebroplasty: A Randomized Trial of Vertebroplasty for Painful Osteoporotic Vertebral Fractures [1] and A Randomized Trial of Vertebroplasty for Osteoporotic Spinal Fractures [2] . As the only multidisciplinary organization representing spine care providers, the North American Spine Society (NASS) has reviewed the studies and crafted the following comments on these important new studies and their significance to patient care.

Download a pdf of the entire paper.

Vertebral Augmentation with a Flexible Curved Needle: Preliminary Results in 17 Consecutive Patients

This report details a trial demonstrating the viability of a blunt-tipped curved needle for use as a cement injection device for vertebral body augmentation. Between January and September 2007, 17 consecutive patients (eight men and nine women; average age, 76 years; age range, 52-97 years) underwent vertebral body augmentation with a blunt-tipped curved nitinol injection needle via a single pedicle to treat pain due to acute vertebral body compression fractures. All patients were successfully treated without complication. The results of the trial demonstrate that a curved blunt-tipped nitinol needle is a viable alternative to a rigid injection cannula when performing vertebral body augmentation with cement.

A Unilateral Vertebroplasty Approach Using a Curved Injection Cannula for Directed, Site-specific Vertebral Body Filling

The present report describes the use of a curved, coaxial infusion cannula that can be applied to facilitate targeted multifocal vertebral body cement injection during vertebroplasty from a single access site. Two representative cases are presented that illustrate the ability of targeted cement deposition and flexible site selection with this technique.