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LETTER TO EDITOR Table of Contents   
Year : 2009  |  Volume : 43  |  Issue : 4  |  Page : 424
Author's reply


1 Spine Service, Inselspital Bern, and Institute for Evaluative Research in Orthopedic Surgery, University of Bern, Bern, Switzerland
2 Spine Service, Inselspital Bern, University Hospital, University of Bern, Bern, Switzerland
3 Osteoporosis Policlinic, University Hospital, University of Bern, Bern, Switzerland
4 Institute for Evaluative Research in Orthopedic Surgery, University of Bern, Bern, Switzerland

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Date of Web Publication23-Sep-2009
 

How to cite this article:
Diel P, Merky D, Roder C, Popp A, Perler M, Heini PF. Author's reply. Indian J Orthop 2009;43:424

How to cite this URL:
Diel P, Merky D, Roder C, Popp A, Perler M, Heini PF. Author's reply. Indian J Orthop [serial online] 2009 [cited 2020 Jan 27];43:424. Available from: http://www.ijoonline.com/text.asp?2009/43/4/424/55981
Sir,

We are thankful for this comment [1] and agree with the colleague's opinion. The usefulness of vertebroplasty [2] should not only be evaluated against the conservative pharmacological treatment but also against newer technologies, like balloon kyphoplasty or vertebral body stenting. The cost-effectiveness study, which is a methodologically challenging study on its own, must include not only pain alleviation but also reoperation caused by new vertebral fractures. We believe that vertebroplasty is, currently, the only technique suitable for prophylactic augmentation and that this approach further increases its cost-effectiveness. As for the availability, the procedure can be performed with very basic equipment: a special formula of polymethylmethacrylate (PMMA) with a high radioopacity is one prerequisite for a safe procedure. Then, one can use simple disposable 8- or 10-gauge biopsy cannulas and inject the cement with 2 and 1 cc syringes. In order to control the cement flow only high-viscosity cement should be injected. A three-level injection accounts for about 250 euros. This is the way it was developed and performed in the earlier days with convincing outcomes and it can still be applied like that if no other material resources are available.

 
   References Top

1.Wiwanitkit V. Vertebroplasty for osteoporotic vertebral fractures: Additional concern on its usefulness. Indian J Orthop 2009;43:419.  Back to cited text no. 1      
2.Diel P, Merky D, Roder C, Popp A, Perler M, Heini PF. Safety and efficacy of vertebroplasty: Early results of a prospective one-year case series of osteoporosis patients in an academic high-volume center. Indian J Orthop 2009;43:228-33.  Back to cited text no. 2    Medknow Journal  

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Correspondence Address:
Christoph Roder
Spine Service, Inselspital Bern, Freiburgstrasse, CH-3010 Bern
Switzerland
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Source of Support: None, Conflict of Interest: None


PMID: 19838399

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