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Additional resources for Balloon Kyphoplasty
The problem of insufﬁcient ﬁlling of a vertebral body resulting from an injection pressure that is too high is not associated with an increase of the intravertebral pressure and is therefore only explainable by a change in the required extravertebral pressure, which has to be regarded as the key factor of the injection process. Methods such as the opening of the shell for release of pressure or making a cavity in the spongiosa do not contribute signiﬁcantly to reduction in the risk of insufﬁcient ﬁlling.
2001; San Millan Ruiz et al. 1999; Wilson et al. 2000]. Until now it has not been possible to develop uniform standards for the cement-injection procedure. Furthermore, there are no clear guidelines from which to choose the parameters necessary for ensuring reproducible and safe injection with a predictable outcome. Because of this situation, the outcome of cement injection is often unpredictable. In the following, we present various studies that have contributed to a clearer understanding and therefore to potential enhancements of the injection process.
2003] 36 sues. The broad ﬁnding was that there is a redistribution of pressure in the augmented model. Closer examination of the pressures shows several important changes. There was a signiﬁcant increase in intravertebral disc pressure (19%), an increased load on L4 (17%), and an increase in joint ﬂexibility (11%). In addition, there was a decrease in the endplate bulge of the superior endplate of L5 and a resulting increase in the endplate bulge of the inferior endplate of L4. These ﬁndings represent an important change in the mechanical loading of the augmented model [Berlemann et al.