Percutaneous Vertebroplasty: Indications, Technique, and Results

Abstract

The authors describe a dedicated therapeutic vertebroplasty technique that uses newly designed instruments, acrylic cement, and dual guidance with ultrasonography and computed tomography for pain control in patients with bone failure, and report their experience. Between 1990 and 2002, they performed 868 percutaneous cementoplasty procedures in patients with severe osteoporosis, vertebral tumors, and symptomatic hemangiomas. In patients with osteoporosis, satisfactory results were obtained in 78% of cases; in patients with vertebral tumors, satisfactory results were obtained in 83% of cases; and in patients with hemangiomas, satisfactory results were obtained in 73% of cases. In the global series of 868 cementoplasties, an epidural leak was observed in 15 cases, which caused neuralgia in only three patients without spinal cord compression. In two patients, an asymptomatic pulmonary embolism was detected. The needle of the new vertebroplasty set is designed with side wings for easier rotation and removal. The screw syringe increases the precision of injection. The risk of leak is substantially reduced. The system is safe, reduces the cement manipulation time, and allows excellent control of the injection. The authors performed 130 vertebroplasties with this system without major complications.

Differences in endplate deformation of the adjacent and augmented vertebra following cement augmentation

“…Bilateral cement augmentation was performed on vertebrae from the fractured and prophylactic group after testing on day 1, using standard vertebroplasty technique [9,12,39] (Fig. 1).…”

Fuga intrarraquídea de cemento biológico tras cifoplastia. Evolución a largo plazo: Presentación de un caso y revisión de la literatura

“…Existen en la literatura gran cantidad de artículos en los que se pone de manifiesto que tanto la HA como otras sales de fosfato cálcico se reabsorben y son sustituidas gradualmente por tejido óseo 10,12,38,41 . Con objeto de evaluar la evolución en el tiempo del cemento usado en nuestro caso, comparamos retrospectivamente los exámenes realizados al paciente con fechas 16 En el examen inicial (figura 1) se observan los dos aportes de cemento desde los pedículos y una fuga de material que llega al espacio epidural siguiendo el agujero nutricio vertebral. En la zona más radioopaca, la densidad del cemento supera ligeramente las 1700 unidades Hounsfield (UH), sobrepasando ampliamente la densidad de la cortical ósea vertebral (1100-1200 UH).…”

“…A pesar de haber demostrado su eficacia en la mejoría del dolor y la calidad de vida de estos pacientes 29,30,33 , es una técnica que no está exenta de complicaciones, siendo la más frecuente de ellas la extravasación del cemento fuera del cuerpo vertebral 11,13,14,16,18,22,46 . Con objeto de conseguir, además de la mejoría del dolor y de la calidad de vida, una restauración parcial de la altura normal del cuerpo vertebral, se desarrolló la técnica de CP, llevada a cabo por primera vez por Reiley en 1998 27 .…”

Percutaneous Spinal Tumor Management

“…Percutaneous injection of methylmethacrylate (Vertebroplasty) provides notable pain relief and spinal strengthening in patients with vertebral tumors (Gangi et Al, 1996, Gangi et Al, 2003.…”