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BackTable / MSK / Podcast / Episode #3

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.

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Modern Vertebral Augmentation with Dr. Douglas Beall on the BackTable MSK Podcast)
Ep 3 Modern Vertebral Augmentation with Dr. Douglas Beall
00:00 / 01:04

BackTable, LLC (Producer). (2023, June 18). Ep. 3 – Modern Vertebral Augmentation [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. Douglas Beall discusses Modern Vertebral Augmentation on the BackTable 3 Podcast

Dr. Douglas Beall

Dr. Douglas Beall is the Chief of Radiology Services at Clinical Radiology of Oklahoma.

Dr. Jacob Fleming discusses Modern Vertebral Augmentation on the BackTable 3 Podcast

Dr. Jacob Fleming

Dr. Jacob Fleming is a diagnostic radiology resident and future MSK interventional radiologist in Dallas, Texas.

Show Notes

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.

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Articles

Topics

Compression Fracture Condition Overview
Kyphoplasty Procedure Prep
Learn about Musculoskeletal Radiology on BackTable MSK
Osteoporosis Condition Overview
Pathologic Fracture Condition Overview
Screw Assisted Internal Fixation Procedure Prep

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