BackTable / VI / Podcast / Episode #210
Modern Vertebral Augmentation
with Dr. Douglas Beall
In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about the latest advances in vertebral augmentation, how to reduce complications, and tips for producing successful and sustainable outcomes.
This podcast is supported by:
Be part of the conversation. Put your sponsored messaging on this episode. Learn how.
BackTable, LLC (Producer). (2022, May 25). Ep. 210 – Modern Vertebral Augmentation [Audio podcast]. Retrieved from https://www.backtable.com
Stay Up To Date
Follow:
Subscribe:
Sign Up:
Podcast Contributors
Dr. Douglas Beall
Dr. Douglas Beall is the Chief of Radiology Services at Clinical Radiology of Oklahoma.
Dr. Jacob Fleming
Dr. Jacob Fleming is a diagnostic radiology resident and future MSK interventional radiologist in Dallas, Texas.
Synopsis
In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall, interventional radiologist, about the latest advances in vertebral augmentation, how to reduce complications, and tips for producing successful and sustainable outcomes. This is the third installment of our 4-part BackTable VI series on osteoporosis treatment.
Dr. Beall begins by discussing the newest technique in the treatment of vertebral compression fractures, screw-assisted vertebral augmentation, with emphasis on how it can decrease the excessive vertebral motion induced by a fracture. He uses the three-column approach (anterior, middle, and posterior column) using SpineJack in the front and pedicle screws in the back. They also discuss vertebral body stents and shaped balloons, two emerging technologies that will be available soon.
Next, they discuss complications in kyphoplasty and vertebral body augmentation. Dr. Beall shares how to recognize various types of cement extravasation. Importantly, if the cement starts to form a lenticular shape, stop injecting because continued injection will cause the cement to enter the spinal canal. The lenticular, biconvex shape that occurs with this pattern is due to the anterior epidural ligaments and midline anterior epidural ligament. He says to let the cement harden in the anterior epidural space once you reach the basivertebral plexus, and then continue injecting. Extravasation, to some degree, is normal, and recognizing where it is going is the key to avoiding complications.
We end by discussing how to improve outcomes. Dr. Beall says that injecting more cement is the best way to produce better outcomes. Lastly, he adds that filling the cleft is the best way to achieve the greatest degree of pain reduction, which ultimately is what indicates a successful outcome.
Resources
Dr. Douglas Beall Twitter:
@DougBeall
BackTable VI Episode 94, Innovation in Spine Interventions with Dr. Douglas Beall:
https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions
Cianfoni publication on Stent-Screw-Assisted Internal Fixation (SAIF):
https://jnis.bmj.com/content/11/6/603
Venmans publication on Pulmonary Emboli during Vertebroplasty:
www.ajnr.org/content/29/10/1983
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.