Percutaneous Vertebroplasty

Abstract

Percutaneous vertebroplasty (PVP) with acrylic cement [polymethylmethacrylate (PMMA)]consists of injecting PMMA into vertebral bodies weakened by osseous lesions. The aim of PVP with PMMA is to obtain an antalgic effect by consolidation in destructive lesions of the spine. There are three major indications: vertebral angiomas, osteoporotic vertebral crush syndromes, and malignant vertebral tumors. Indications in vertebral angiomas only concern patients with aggressive clinical signs (severe pain or nervous compression) and/or aggressive radiological signs. Indications in osteoporotic vertebral crush syndromes only concern patients suffering from back pain related to one or two adjacent vertebral collapses resistant to medical treatment for several weeks. Indications in malignant vertebral tumors only concern patients suffering from severe back pain related to a destruction of the vertebral body, not involving the major part of the cortical bone. Complications of PVP occur essentially in patients with vertebral metastasis. In the great majority of cases, these complications heal under medical treatment. In patients with osteoporotic vertebral crush syndromes or vertebral angiomas, the complications are represented by the increase or onset of radiculalgias (in less than 1%), which disappear after local anesthetic injection.