[Percutaneous vertebroplasty for vertebral fractures caused by multiple myeloma, an aggressive vertebral haemangioma and in a traumatic burst fracture]

Abstract

Percutaneous vertebroplasty (PVP) using polymethylmethacrylate bone cement is frequently used in the treatment of painful osteoporotic vertebral compression fractures in the Netherlands. In three patients there was another indication. A 44-year-old woman suffering from vertebral pain due to an osteolytic lesion caused by multiple myeloma was treated with vertebroplasty of 4 vertebral levels. A 60-year-old woman with progressive complaints of back pain due to an aggressive vertebral haemangioma was treated with vertebroplasty after embolisation had only been partially successful. Lastly, a 50-year-old non-osteoporotic man with back pain persisting for six weeks due to a stable traumatic burst fracture of TIX could not be treated with standard care, i.e. corset and analgesics, because of obesity. He was treated with PVP after a cavity had been created in the vertebral corpus. Vertebroplasty is a minimal invasive procedure resulting in most patients in rapid diminishment of the pain caused by pathological vertebral fractures, which may be present for a longer period and may have different causes. The indication triad for vertebroplasty consists of localised back pain, pain when pressure is applied to the processus spinosus of the fractured level and MRI bone oedema, findings suggestive of microfractures in a pathologically changed vertebral body. The procedure is also suitable in patients with extensive comorbidity or a short life expectancy.