Innovations and solutions for patients with Osteoporosis and Vertebral Fractures
„Nature makes us alike, education makes us different” Confucius. With this thought in mind, we have formed a small Team of Romanian doctors from various specialties (Spinal Neurosurgery and Interventional Radiology) and here we re-open the bracket to Spinal Orthopedics because this branch of orthopedics also diagnoses and treats spinal disorders, and I accepted the invitation of the Tecres Italia company for 2 days of intensive training, presentations, workshop and Cadaver Lab all related to the specific pathologies associated with Osteoporosis for which there are minimally invasive treatment solutions through Vertebroplasty.
First day
It was dedicated to practice within a Cadaver Lab, an extremely applied type of course, which respects some very strict rules for the selection of participants, the methods used, the specimens dedicated to the practical courses, the elements used. All those involved received special operating room suits, aprons and full lead shields for interacting with the C-arm X-ray machines which were used similar to the actual operations, and the training kits in the 3 different techniques with 3 types of vertebroplasty and cement (low, medium and high-viscosity) were sterile, same as those in the operating room.
The cadaver lab was hosted by the Demetra group, which also includes Tecres and ICLO, an Institute specialized in specimen courses for doctors. Physicians primarily experienced anatomy and imaging concepts relative to pedicle targeting to subsequently correctly insert a vertebroplasty needle through the pedicle into the vertebral body and also experienced their craft with Mendec Spine injection systems (low viscosity ), a pressure gun injection kit to have force and control over the injection of cement and taught the types of mixing, handling and curing to prevent possible complications.
The next day
On March 8 (Women’s Day) Tecres organized the International Congress in a Castle near Verona, in a magnificent location set on a hill with a superb view of the nearby vineyards and plains, a restored medieval estate surrounded by lemon trees with fruits, exotic trees, renaissance sculptures scattered in an architecture merged with nature and Halls with picture Art Nuveau.
The International Congress and Conference organized by Tecres on March 8 had several meanings: first of all, it celebrated International Women’s Day, then it marked the multiple presentations, the continuous research effort of doctors and the company to find solutions for the diagnosis and treatment of the effects of Osteoporosis on the spine, especially on elderly women, especially during menopause and their side effects (fractures, subsidence, meningiomas, pathological and oncological aspects)
Involved lecturers
The lecturers involved in the Cadaver Lab and in the lectures of the Tecres international congress are medical specialists practicing in various specialties and have lectured on solved cases, failed cases, risks of vertebroplasty and solving by hybrid reconstruction together with other medical devices.
Among the Lecturers and themes presented in the Tecres conference
- Luca Carreri, Verona – Italy, Tecres to Demetra
- Mendec line products, Giovanni Calonego and Monica Ferrari, Verona – Italy
- Radiological diagnosis and classification of vertebral compression fractures. Tips of imaging guidance in vertebral procedures, Matteo Bellini, Siena – Italy
- Biomechanical considerations for the treatment of the osteoporotic fracture
- Marco Pileggi, Lugano – Switzerland
- Vertebral augmentation: vertebroplasty, balloon kyphoplasty and other kyphoplasty devices, Stefano Marcia, Cagliari – Italy
- Literature review on resin viscosity (low vs high) and clinical experience with high viscosity resins, Luka Novosel, Zagreb – Croatia
- Percutaneous stabilization treatment of severe osteoporotic fractures and extreme neoplastic lesions: SAIF technique, Alessandro Cianfoni, Lugano – Switzerland
- Vertebral augmentation in trauma patients and screw augmentation
- Vertebral augmentation vs conservative treatment: longer life expectancy for treated patients, Stefano Marcia, Cagliari – Italy
After the presentations and the discussed cases, another practical workshop was held which restated the practical, technical, manual aspects, mixing times, injection, strengthening and selection according to the clinical cases of the 3 main types of vertebroplasty solutions:
- Mendec Spine Kit ( Low Viscosity)
- Mendec Spine MV system (Medium Viscosity)
- Mendec Spine HV (High Viscosity)
- Mendec Aqua
- Extruder
- Bone filler (Kyphoplasty)
- Standard Cement
- Needles
I have to admit that out of my passion for wines and pairing, because I have been to a splendid area of Italy where liqueurs intertwine with poetry, the sky meets nymphs and the tastes recall Romeo’s shared love for Juliet, I leave a few below from those tasted and tried there. Beyond that, I see things with intertwined meanings: education goes very well with socializing, doctors appreciate a special wine, and the tannins of Amarone Valpolicella can surround a parmesan risotto that crowns the excitement of the 6th taste of Umami on the palate of the thirst for knowledge.
The centers and doctors who perform Vertebroplasty with the above systems are the following:
- Bucharest University Emergency Hospital (SUUB), Interventional Radiology – Dr. Bogdan Dorobat and the team
- National Institute of Neurology and Neurovascular Diseases (INNBN), Interventional Radiology – Dr. Razvan Stanciulescu and the team
- Bagdasar-Arseni Emergency Clinical Hospital, Neurosurgery – Dr. Daniel Serban and the team
- Colentina Clinical Hospital – Neurosurgery and Spinal Orthopedic – Dr. Mihai Magureanu- Dr. Horatiu Ioani, Dr. Mihai Craciun and the team
- Central Military Emergency University Hospital „Dr. Carol Davila”, Interventional Radiology – Dr. Sebastian Botezatu, Dr. Cezar Betianu and the team
- Bucharest Clinical Emergency Hospital (Floreasca), Neurosurgery – Dr. Gabriel Dascalu, Dr. Mircea Sklerniacof, Dr. Vadim Palii
- Sfântul Pantelimon Emergency Clinical Hospital, Interventional Radiology – Dr. Viorel Pârlea (Lt. col. (r.)), Dr. Andrei Deaconu, Neurosurgery – Dr. Marius Papacocea and team, Orthopedics – Prof. Dr. Stefan Cristea and team
- Oradea County Emergency Clinical Hospital, Interventional Radiology Dr. Dan Mihoc and the team, Neurosurgery Dr. Alin Blaga, Dr. Linda Iszlai, Dr. Aurel Mohan and the team
- „Sfântul Ioan cel Nou” Emergency County Clinical Hospital (Suceava) Interventional Radiology – Dr. Mihai Creteanu and the team, Neurosurgery – Dr. Anatolii Buzdugan and the team
- Pitesti County Emergency Hospital – Neurosurgery – Dr. Mihai Marinoica and the team
- SANADOR, Neurosurgery – Prof. Dr. A. V. Ciurea, Dr. Ionut Luca Husti, Dr. Dan Bentia and the team
- Emergency Clinical Hospital „Prof. Dr. Nicolae Oblu” from Iasi, Neurosurgery – Dr. Cezar Popescu, Dr. Bogdan Costachescu and the team
- Clinic Polisano Sibiu, Neurosurgery – Dr. Matei Claudiu and the team
- Craiova County Emergency Clinical Hospital, Interventional Radiology – Dr. Cristian Constantin and the team
Thanks to all the doctors and centers above.
Special thanks to Mr. Dr. Dan Mihoc, Head of the Interventional Radiology Department, SJU Oradea for the curiosity to deepen the minimally-invasive surgical techniques of vertebroplasty in parallel with the Endovascular treatment techniques for Aneurysms, Stenosis and Stroke, but also to the other doctors in the country who are dedicated their job and make enormous sacrifices saving patients’ lives and changing their quality of life in a totally underfunded healthcare system.
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