High-viscosity cement shows comparable leakage rate to kyphoplasty


Bassem Georgy , University of California, San Diego, USA presented data on the results of a study which showed that highly viscous cement may increase the safety of standard vertebroplasty techniques.


Speaking at the annual meeting of the Society of Interventional Radiology, held in San Diego between 7-12 March, Georgy noted that vertebroplasty is known for its high leakage rate compared to kyphoplasty.

He said, “High viscosity cements have been shown to significantly enhance uniformity of cement filling and decrease incidence of leakage. New products for vertebral body augmentation, such as Confidence, are therefore providing high-viscosity cements with precision delivery systems.”

Depuy, the company that makes this cement, says that the Confidence system consists of a proprietary hydraulic-based delivery system that provides precise placement of a specially formulated high viscosity polymethylmethacrylate bone cement directly into vertebral bodies to stabilise fractures and potentially reduce pain.

The results of his study revealed that the use of high- viscosity Confidence cement result in leakage rates comparable to that of kyphoplasty. Georgy said, “Highly viscous cement may increase the safety of standard vertebroplasty techniques. In this study, the incidence and pattern of cement leakage with Confidence was compared to that of standard kyphoplasty.”

Materials and methods of the study

Post-operative radiographs of patients treated with either kyphoplasty or Confidence were analysed for cement leakage, using a stringent and thorough 4-point scale (none; mild; moderate; severe). When leakage was observed, l ocation of cement leakage was also recorded as: discal, venous (paravertebral), or epidural.

Results: 65 patients with 105 treated levels were included in this retrospective review. There were 47 kyphoplasty vs. 58 confidence levels, which ranged from T1 to L5. The average vertebral collapse reached 26% in the Confidence group and 25% in the kyphoplasty group. There was no or minimal/mild leakage in 91% Confidence and 85% Kyphone cases. Severe leakage was reported in just 1 (2%) Confidence and 1 (2%) Kyphon cases. In both cases, the severe leakage was found in the disc space. No significant leakage was noticed that required any surgical intervention.


G.Baroud, M. Crookshank, M.Bohner, High-viscosity cement significantly enhances uniformity of cement filling in Vertebroplasty: an experimental model and study on cement leakage. Spine 31, 2562,2006.