{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:24:12Z","timestamp":1788287052582,"version":"build-2803163510"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,7,11]],"date-time":"2020-07-11T00:00:00Z","timestamp":1594425600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,11]],"date-time":"2020-07-11T00:00:00Z","timestamp":1594425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81401849"],"award-info":[{"award-number":["81401849"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Surg Res"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Percutaneous vertebroplasty is the most common treatment for osteoporotic vertebral compression fracture. However, the morbidity of vertebroplasty-related complications, such as cement leakage, remains high. We tested a new technique of unilateral pulsed jet lavage and investigated its effect on the intravertebral pressure and bone cement distribution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty lumbar vertebrae (L1-L5) from six cadaver spines were randomly allocated into two groups (with and without irrigation). Prior to vertebroplasty, pulsed jet lavage was performed through one side of the pedicle by using a novel cannula with two concentric conduits to remove the fat and bone marrow of the vertebral bodies in the group with irrigation. The control group was not irrigated. Then, standardized vertebroplasty was performed in the vertebral bodies in both groups. Changes in the intravertebral pressure during injection were recorded. Computed tomography (CT) was performed to observe the cement distribution and extravasations, and the cement mass volume (CMV) was calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During cement injection, the average maximum intravertebral pressure of the unirrigated group was higher than that of the irrigated group (4.92\u2009kPa versus 2.22\u2009kPa,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05). CT scans showed a more homogeneous cement distribution with less CMV (3832\u2009mm\n                      <jats:sup>3<\/jats:sup>\n                      vs. 4344\u2009mm\n                      <jats:sup>3<\/jats:sup>\n                      ,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05) and less leakage rate (6.7% vs. 46.7%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05) in the irrigated group than in the control group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Unilateral pulsed jet lavage can reduce intravertebral pressure and lower the incidence of cement leakage during vertebroplasty. An enhanced bone cement distribution can also be achieved through this lavage system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13018-020-01779-3","type":"journal-article","created":{"date-parts":[[2020,7,11]],"date-time":"2020-07-11T00:52:57Z","timestamp":1594428777000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effect of unilateral pulsed jet lavage prior to vertebroplasty on the intravertebral pressure and cement distribution"],"prefix":"10.1186","volume":"15","author":[{"given":"Jun","family":"Yan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaohui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3842-8013","authenticated-orcid":false,"given":"Yanping","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziqun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penghui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suomao","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghao","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanlong","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,7,11]]},"reference":[{"issue":"19","key":"1779_CR1","doi-asserted-by":"publisher","first-page":"E1266","DOI":"10.1097\/BRS.0b013e31820a0b3f","volume":"36","author":"MC Gerling","year":"2011","unstructured":"Gerling MC, Eubanks JD, Patel R, Whang PG, Bohlman HH, Ahn NU. Cement augmentation of refractory osteoporotic vertebral compression fractures. Spine. 2011;36(19):E1266\u20139.","journal-title":"Spine"},{"issue":"12","key":"1779_CR2","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.1016\/j.spinee.2013.06.054","volume":"13","author":"SG Pneumaticos","year":"2013","unstructured":"Pneumaticos SG, Triantafyllopoulos GK, Evangelopoulos DS, Hipp JA, Heggeness MH. Effect of vertebroplasty on the compressive strength of vertebral bodies. The Spine Journal. 2013;13(12):1921\u20137.","journal-title":"The Spine Journal"},{"issue":"8","key":"1779_CR3","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1097\/00007632-200004150-00005","volume":"25","author":"JD Barr","year":"2000","unstructured":"Barr JD, Barr MS, Lemley TJ, McCann RM. Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine (Phila Pa 1976). 2000;25(8):923\u20138.","journal-title":"Spine (Phila Pa 1976)"},{"issue":"S02","key":"1779_CR4","doi-asserted-by":"publisher","first-page":"S85","DOI":"10.1007\/s00198-004-1723-1","volume":"16","author":"PF Heini","year":"2004","unstructured":"Heini PF. The current treatment\u2014a survey of osteoporotic fracture treatment. Osteoporotic spine fractures: the spine surgeon\u2019s perspective. Osteoporosis International. 2004;16(S02):S85\u201392.","journal-title":"Osteoporosis International"},{"issue":"9746","key":"1779_CR5","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1016\/S0140-6736(10)60954-3","volume":"376","author":"CAH Klazen","year":"2010","unstructured":"Klazen CAH, Lohle PNM, de Vries J, Jansen FH, Tielbeek AV, Blonk MC, et al. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. The Lancet. 2010;376(9746):1085\u201392.","journal-title":"The Lancet"},{"issue":"23","key":"1779_CR6","first-page":"E906","volume":"33","author":"LM Benneker","year":"2008","unstructured":"Benneker LM, Heini PF, Suhm N, Gisep A. The effect of pulsed jet lavage in vertebroplasty on injection forces of polymethylmethacrylate bone cement, material distribution, and potential fat embolism: a cadaver study. Spine (Phila Pa 1976). 2008;33(23):E906\u201310.","journal-title":"Spine (Phila Pa 1976)"},{"issue":"12","key":"1779_CR7","doi-asserted-by":"publisher","first-page":"1957","DOI":"10.1007\/s00586-009-1079-5","volume":"18","author":"A Boger","year":"2009","unstructured":"Boger A, Benneker LM, Krebs J, Boner V, Heini PF, Gisep A. The effect of pulsed jet lavage in vertebroplasty on injection forces of PMMA bone cement: an animal study. Eur Spine J. 2009;18(12):1957\u201362.","journal-title":"Eur Spine J"},{"issue":"11","key":"1779_CR8","doi-asserted-by":"publisher","first-page":"1913","DOI":"10.1007\/s00586-010-1555-y","volume":"19","author":"LM Benneker","year":"2010","unstructured":"Benneker LM, Krebs J, Boner V, Boger A, Hoerstrup S, Heini PF, et al. Cardiovascular changes after PMMA vertebroplasty in sheep: the effect of bone marrow removal using pulsed jet-lavage. European Spine Journal. 2010;19(11):1913\u201320.","journal-title":"European Spine Journal"},{"issue":"5","key":"1779_CR9","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1177\/2192568218803106","volume":"9","author":"CE Albers","year":"2018","unstructured":"Albers CE, Schott PM, Ahmad SS, Benneker LM, Nieuwkamp N, Hoppe S. Vertebral body lavage reduces hemodynamic response to vertebral body augmentation with PMMA. Global Spine Journal. 2018;9(5):499\u2013504.","journal-title":"Global Spine Journal"},{"issue":"11","key":"1779_CR10","doi-asserted-by":"publisher","first-page":"3463","DOI":"10.1007\/s00586-015-4191-8","volume":"25","author":"S Hoppe","year":"2016","unstructured":"Hoppe S, Elfiky T, Keel MJ, Aghayev E, Ecker TM, Benneker LM. Lavage prior to vertebral augmentation reduces the risk for cement leakage. Eur Spine J. 2016;25(11):3463\u20139.","journal-title":"Eur Spine J"},{"issue":"11","key":"1779_CR11","doi-asserted-by":"publisher","first-page":"3439","DOI":"10.1007\/s00586-016-4395-6","volume":"25","author":"X Cheng","year":"2016","unstructured":"Cheng X, Long H-Q, Xu J-H, Huang Y-L, Li F-B. Comparison of unilateral versus bilateral percutaneous kyphoplasty for the treatment of patients with osteoporosis vertebral compression fracture (OVCF): a systematic review and meta-analysis. European Spine Journal. 2016;25(11):3439\u201349.","journal-title":"European Spine Journal"},{"key":"1779_CR12","doi-asserted-by":"crossref","unstructured":"Sun H, Li C. Comparison of unilateral and bilateral percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a systematic review and meta-analysis, Journal of Orthopaedic Surgery and Research. 2016;11(1):156.","DOI":"10.1186\/s13018-016-0479-6"},{"issue":"2","key":"1779_CR13","doi-asserted-by":"publisher","first-page":"E85","DOI":"10.1097\/BSD.0000000000000147","volume":"28","author":"LG Zhang","year":"2015","unstructured":"Zhang LG, Gu X, Zhang HL, Zhang QG, Cai XB, Tao K. Unilateral or bilateral percutaneous vertebroplasty for acute osteoporotic vertebral fracture: a prospective study. J Spinal Disord Tech. 2015;28(2):E85\u20138.","journal-title":"J Spinal Disord Tech"},{"key":"1779_CR14","doi-asserted-by":"crossref","unstructured":"Yan L, He B, Guo H, Liu T, Hao D. The prospective self-controlled study of unilateral transverse process-pedicle and bilateral puncture techniques in percutaneous kyphoplasty, Osteoporosis International. 2015;27(5):1849\u201355.","DOI":"10.1007\/s00198-015-3430-5"},{"issue":"8","key":"1779_CR15","doi-asserted-by":"publisher","first-page":"E301","DOI":"10.1097\/BSD.0000000000000118","volume":"27","author":"C Chen","year":"2014","unstructured":"Chen C, Bian J, Zhang W, Zhang W, Zhao C, Wei H. Unilateral versus bilateral vertebroplasty for severe osteoporotic vertebral compression fractures. J Spinal Disord Tech. 2014;27(8):E301\u20134.","journal-title":"J Spinal Disord Tech"},{"issue":"5","key":"1779_CR16","doi-asserted-by":"publisher","first-page":"e0176934","DOI":"10.1371\/journal.pone.0176934","volume":"12","author":"C Zhao","year":"2017","unstructured":"Zhao C, Sun Y, Jiang W, Cory E, Caffrey JP, Hsu FH, et al. Pulsed lavage cleansing of osteochondral grafts depends on lavage duration, flow intensity, and graft storage condition. Plos One. 2017;12(5):e0176934.","journal-title":"Plos One"},{"issue":"3","key":"1779_CR17","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1097\/BRS.0b013e3181b63673","volume":"35","author":"R Mohamed","year":"2010","unstructured":"Mohamed R, Silbermann C, Ahmari A, Bohner M, Becker S, Baroud G. Cement filling control and bone marrow removal in vertebral body augmentation by unipedicular aspiration technique: an experimental study using leakage model. Spine (Phila Pa 1976). 2010;35(3):353\u201360.","journal-title":"Spine (Phila Pa 1976)"},{"issue":"6","key":"1779_CR18","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.1007\/s00586-018-5804-9","volume":"28","author":"O Hershkovich","year":"2018","unstructured":"Hershkovich O, Lucantoni C, Kapoor S, Boszczyk B. Bone marrow washout for multilevel vertebroplasty in multiple myeloma spinal involvement. Technical note. European Spine Journal. 2018;28(6):1455\u201360.","journal-title":"European Spine Journal"},{"issue":"1","key":"1779_CR19","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s13018-015-0160-5","volume":"10","author":"K Li","year":"2015","unstructured":"Li K, Yan J, Yang Q, Li Z, Li J. The effect of void creation prior to vertebroplasty on intravertebral pressure and cement distribution in cadaveric spines with simulated metastases. Journal of Orthopaedic Surgery and Research. 2015;10(1):20.","journal-title":"Journal of Orthopaedic Surgery and Research"}],"container-title":["Journal of Orthopaedic Surgery and Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-020-01779-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13018-020-01779-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-020-01779-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T19:37:53Z","timestamp":1625945873000},"score":1,"resource":{"primary":{"URL":"https:\/\/josr-online.biomedcentral.com\/articles\/10.1186\/s13018-020-01779-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,11]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1779"],"URL":"https:\/\/doi.org\/10.1186\/s13018-020-01779-3","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-21709\/v1","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-21709\/v2","asserted-by":"object"}]},"ISSN":["1749-799X"],"issn-type":[{"value":"1749-799X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,11]]},"assertion":[{"value":"6 April 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 July 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the ethics committee of Shandong University.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"259"}}