Abstract
Percutaneous vertebroplasty is a safe and successful method for the treatment of vertebral lesions due to osteoporotic fractures, metastatic lesions or haemangiomas. The procedure involves the percutaneous injection of polymethyl methacrylate (PMMA) into a pathological vertebral body. The technique is described in detail together with potential complications. Strict adherence to selection criteria, a multidisciplinary approach and the need for excellent imaging equipment are stressed.
Highlights
Percutaneous vertebroplasty has been performed in France by interventional radiologists since 1984 and involves the percutaneous injection of polymethyl methacrylate (PMMA) into a pathological vertebral body.' Currently the same procedure is being used for the treatment of metastatic lesions in different parts of the skeleton, but for the purposes of this article I will confine the discussion to the treatment of vertebral lesions
In 1998 there were 10 - 12 physicians performing the procedure in the USA; by 2001, 500 interventional radiologists had been trained and were performing percutaneous vertebroplasties
Vertebroplasty must not be mistaken for kyphoplastywhere a balloon is first inserted into the collapsed vertebra to try to restore some height before cement is injected
Summary
Percutaneous vertebroplasty has been performed in France by interventional radiologists since 1984 and involves the percutaneous injection of polymethyl methacrylate (PMMA) into a pathological vertebral body.' Currently the same procedure is being used for the treatment of metastatic lesions in different parts of the skeleton (e.g. the acetabulum), but for the purposes of this article I will confine the discussion to the treatment of vertebral lesions. In the USA the procedure is more commonly used in the treatment of osteoporotic vertebral fractures than in malignant lesions. This is in part because in the USA it is largely a patient-driven procedure, with the patients having Internet 'savvy' and referring themselves directly. The procedure is minimally invasive and leads to marked reduction or cure of pain together with the mechanical strengthening of the bone. It is usually done as an outpatient procedure with a success rate of between 80% and 90%.2. Vertebroplasty must not be mistaken for kyphoplastywhere a balloon is first inserted into the collapsed vertebra to try to restore some height before cement is injected
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