Patient Evaluation and Selection

Stallmeyer, M.J.B.; Zoarski, Gregg H.

doi:10.1007/0-387-36083-2_5

Cited by 6 publications

(11 citation statements)

References 84 publications

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“…The presence of neurologic symptoms from nerve root or spinal cord compression, other than localized pain, is accepted by most authors as a contraindication to the performance of PVP (20,30,31). The presence of destruction of the posterior vertebral wall or epidural retropulsion without direct compressive symptoms has been described as a relative contraindication to the procedure (20 -24), since there is increased risk of symptomatic extravasation of PMMA into the spinal canal or neural foramina.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Vertebroplasty for Malignant Compression Fractures with Epidural Involvement

Shimony¹,

Gilula²,

Zeller³

et al. 2004

Radiology

136

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Section: Discussionmentioning

confidence: 99%

Percutaneous Vertebroplasty for Malignant Compression Fractures with Epidural Involvement

Shimony¹,

Gilula²,

Zeller³

et al. 2004

Radiology

136

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“…Healed vertebral compression fractures, however, may show normal signal. 6,9 If MR cannot be performed, bone scintigraphy is considered the next best alternative and may provide enough information to decide if vertebroplasty is appropriate, 6 especially when combined with CT. CT is best for detecting destruction of the posterior vertebral wall and determining whether the lesion is osteoblastic or osteolytic. 7 The patient should also undergo a preanesthetic evaluation, electrocardiogram, complete blood cell count, platelets, electrolytes, prothrombin time, partial thromboplastin time, blood urea nitrogen, and creatinine.…”

Section: Imaging and Laboratory Studiesmentioning

confidence: 99%

“…Absolute contraindications to vertebroplasty and kyphoplasty include active local infection, such as osteomyelitis, discitis, or epidural abscess, or if fever or sepsis is present. 6 Such patients should be postponed until these problems resolve. Patients with bleeding diatheses (platelets < 100,000, prothrombin time > 1.6, and partial thromboplastin time > 1.5 times normal) should have their coagulopathy controlled before the procedure.…”

Section: Contraindicationsmentioning

confidence: 99%

“…Proper patient selection is crucial because more than 80% of the population experiences back pain at some time in their life. 6 To distinguish pain from other causes requires a careful correlation of the patient's history with clinical examination and available imaging. Patients may be referred for three main reasons: for known cancer and back pain related to a spinal metastasis, known cancer and a recently diagnosed but asymptomatic spinal lesion, or back pain and suspicious lesions but no known diagnosis.…”

mentioning

confidence: 99%

“…7 On clinical examination, focal pain should be present that correlates with the lesion being considered for treatment, pain should typically worsen with weightbearing and improve in the recumbent position, and it should lack the symptoms of nerve root or cord compression. [6][7][8] In addition, the pain should be severe enough that it affects daily activities or requires substantial amounts of analgesics. It is also recommended that pain levels should be documented and quantified with questionnaires or the visual analogue scale.…”

mentioning

confidence: 99%

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Vertebroplasty and Kyphoplasty for the Palliation of Pain

Shaibani

Ali²,

Bhatt³

2007

Semin intervent Radiol

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Vertebroplasty and kyphoplasty are percutaneous techniques developed over the past 20 years to treat vertebral hemangiomas, osteoporotic compression fractures, and osteolytic tumors of the spine. In carefully selected patients, these procedures have led to the cessation or significant reduction in pain in 80 to 90% of patients. In this article, we review the indications and contraindications of these procedures, appropriate patient selection and evaluation, the technique, outcomes, and the potential complications of this form of therapy when performed for the alleviation of pain for osteolytic tumors of the spine.

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C2/C3 pathologic fractures from polyostotic fibrous dysplasia of the cervical spine treated with percutaneous vertebroplasty

et al. 2007

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We will discuss a potential role of percutaneous vertebroplasty (PVP) in the management of patients with severe fibrous dysplasia of the spine with multiple cervical lesions and C2-C3 pathologic fractures that may not be a good surgical candidate. Polyostotic fibrous dysplasia involvement of the cervical spine is rare. Review of literature indicates only few reported cases of surgical management with one case of mortality indicating increased risks associated with surgical intervention. While PVP is commonly used for the treatment of osteoporotic thoracolumbar vertebral compression fractures, its role in vertebral stabilization for fibrous dysplasia has not been reported. A 35-year-old man with McCune-Albright syndrome and severe polyostotic fibrous dysplasia of C2 and C3 vertebrae presented with severe neck pain, radiculopathy, quadriparesis and myelopathy. The lesion had pathologic fractures, and there was an os odontoideum with cervical cord atrophy at the C1 level. After discussing need for aggressive surgical management and potential complications, we offered PVP due to surgical risks involved. PVP was performed with a posterolateral transpedicular approach without complication. The patient had remarkable improvement in clinical relief of neck pain and improvement of myelopathic symptoms at 1-year follow-up. We present a case that illustrates a potential use of PVP in the management of a patient with symptomatic spinal fibrous dysplasia with associated pathologic fractures who was poor surgical candidate.

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Patient Evaluation and Selection

Cited by 6 publications

References 84 publications

Percutaneous Vertebroplasty for Malignant Compression Fractures with Epidural Involvement

Percutaneous Vertebroplasty for Malignant Compression Fractures with Epidural Involvement

Vertebroplasty and Kyphoplasty for the Palliation of Pain

C2/C3 pathologic fractures from polyostotic fibrous dysplasia of the cervical spine treated with percutaneous vertebroplasty

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