vertebroplasty

Vertebroplasty is an imaging-guided procedure which entails percutaneous injection of surgical polymethylmethacrylate (PMMA) cement into a diseased vertebral body. Vertebroplasty provides pain relief and strengthening of the bone of vertebrae weakened by disease.

Indications

It can be used as a treatment or as a palliative measure for:

Contraindications

Absolute contraindications
  • septicemia
  • active osteomyelitis of the target vertebra
  • uncorrectable coagulopathy
  • allergy to bone cement or opacifying agent
Relative contraindications
  • radiculopathy beyond local vertebral pain, caused by a compressive syndrome unrelated to vertebral collapse
    • occasionally, preoperative vertebroplasty can be performed before a spinal decompressive procedure
  • retropulsion of a fracture fragment or epidural tumor extension causing signs and symptoms of neurological compromise
  • current systemic infection
  • patient improving on medical therapy
  • prophylaxis in osteoporotic patients
  • myelopathy or cauda equina syndrome originating at the fracture level

Complications

  • leakage of vertebroplasty
    • compression of adjacent structures
    • inferior vena cava syndrome
  • cement extravasation