Percutaneous Vertebroplasty

ABSTRACT

The goal of percutaneous vertebroplasty (PVP) is to provide relief of pain related to vertebral compression fracture. First used in the treatment of malignant compression fractures, its natural extension to the care of osteoporotic fractures opened a much larger market. This article will discuss the indications, patient work-up, procedural technique, and postoperative care for PVP. Potential complications will be addressed. The article will conclude with a brief discussion of future trends in the treatment of osteoporosis.

KEYWORDS

Vertebral compression fracture - vertebroplasty - osteoporosis

REFERENCES

• 1 Barr J D, Barr M S, Lemley T J. Percutaneous vertebroplasty for pain relief and spinal stabilization.  Spine . 2000;  25 923-928
• 2 Hardouin P, Grados F, Cotten A. Should percutaneous vertebroplasty be used to treat osteoporotic fractures?.  <~>An update. Joint Bone Spine . 2001;  68 216-221
• 3 Deramond H, Depriester C, Toussaint P. Percutaneous vertebroplasty.  Semin Musculoskelet Radiol . 1997;  1 285-296
• 4 Mathis J M, Barr J D, Belkoff S M. Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures.  AJNR Am J Neuroradiol . 2001;  22 373-381
• 5 Grados F, Depriester C, Cayrolle G. Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty.  Rheumatology (Oxford) . 2000;  39 1410-1414
• 6 Jensen M E, Dion J E. Percutaneous vertebroplasty in the treatment of osteoporotic compression fractures.  Neuroimaging Clin N Am . 2000;  10 547-568
• 7 Levine S A, Perin L A, Hayes D. An evidence-based evaluation of percutaneous vertebroplasty.  Managed Care . 2000;  9 56-63
• 8 Cortet B, Cotten A, Boutry N. Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study.  J Rheumatol . 1999;  26 2222-2228
• 9 Deramond H, Depriester C, Galibert P. Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results.  Radiol Clin North Am . 1998;  36 533-546
• 10 Murphy K J, Deramond H. Percutaneous vertebroplasty in benign and malignant disease.  Neuroimaging Clin N Am . 2000;  10 535-545
• 11 Cortet B, Cotten A, Boutry N. Percutaneous vertebroplasty in patients with osteolytic metastases or multiple myeloma.  Rev Rhum Engl Ed . 1997;  64 145-146
• 12 Ide C, Gangi A, Rimmelin A. Vertebral haemangiomas with spinal cord compression: the place of preoperative percutaneous vertebroplasty with methyl methacrylate.  Neuroradiology . 1996;  38 585-589
• 13 Cotten A, Dewatre F, Cortet B. Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up.  Radiology . 1996;  200 525-530
• 14 Feydy A, Cognard C, Miaux Y. Acrylic vertebroplasty in symptomatic cervical vertebral haemangiomas: report of 2 cases.  Neuroradiology . 1996;  38 389-391
• 15 Weill A, Chiras J, Simon J M. Spinal metastases: indications for and results of percutaneous injection of acrylic surgical cement.  Radiology . 1996;  199 241-247
• 16 Galibert P, Deramond H, Rosat P. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty.  Neurochirurgie . 1987;  33 166-168
• 17 Do H M. Magnetic resonance imaging in the evaluation of patients for percutaneous vertebroplasty.  Top Magn Reson Imaging . 2000;  11 235-244
• 18 Maynard A S, Jensen M E, Schweickert P A. Value of bone scan imaging in predicting pain relief from percutaneous vertebroplasty in osteoporotic vertebral fractures.  AJNR Am J Neuroradiol . 2000;  21 1807-1812
• 19 Jensen M E, Evans A J, Mathis J M. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects.  AJNR Am J Neuroradiol . 1997;  18 1897-1904
• 20 Appel N B, Gilula L A. ``Bull's-eye'' modification for transpedicular biopsy and vertebroplasty.  AJR Am J Roentgenol . 2001;  177 1387-1389
• 21 Jasper L E, Deramond H, Mathis J M. The effect of monomer-to-powder ratio on the material properties of cranioplastic.  Bone . 1999;  25 27S-29S
• 22 Belkoff S M, Maroney M, Fenton D C. An in vitro biomechanical evaluation of bone cements used in percutaneous vertebroplasty.  Bone . 1999;  25 23S-26S
• 23 Tong F C, Cloft H J, Joseph G J. Transoral approach to cervical vertebroplasty for multiple myeloma.  AJR Am J Roentgenol . 2000;  175 1322-1324
• 24 Ratliff J, Nguyen T, Heiss J. Root and spinal cord compression from methylmethacrylate vertebroplasty.  Spine . 2001;  26 E300-E302
• 25 Harrington K D. Major neurological complications following percutaneous vertebroplasty with polymethylmethacrylate: a case report.  J Bone Joint Surg Am . 2001;  83-A 1070-1073
• 26 Padovani B, Kasriel O, Brunner P. Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty.  AJNR Am J Neuroradiol . 1999;  20 375-377
• 27 Vasconcelos C, Gailloud P, Martin J B. Transient arterial hypotension induced by polymethylmethacrylate injection during percutaneous vertebroplasty.  J Vasc Interv Radiol . 2001;  12 1001-1002
• 28 Deramond H, Wright N T, Belkoff S M. Temperature elevation caused by bone cement polymerization during vertebroplasty.  Bone . 1999;  25 17S-21S
• 29 Heini P F, Berlemann U. Bone substitutes in vertebroplasty.  Eur Spine J . 2001;  10(Suppl 2) S205-S213
• 30 Hitchon P W, Goel V, Drake J. Comparison of the biomechanics of hydroxyapatite and polymethylmethacrylate vertebroplasty in a cadaveric spinal compression fracture model.  J Neurosurg . 2001;  95 215-220
• 31 Belkoff S M, Mathis J M, Jasper L E. An ex vivo biomechanical evaluation of a hydroxyapatite cement for use with vertebroplasty.  Spine . 2001;  26 1542-1546
• 32 Cunin G, Boissonnet H, Petite H. Experimental vertebroplasty using osteoconductive granular material.  Spine . 2000;  25 1070-1076
• 33 Garfin S R, Yuan H A, Reiley M A. New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures.  Spine . 2001;  26 1511-1515
• 34 Watts N B, Harris S T, Genant H K. Treatment of painful osteoporotic vertebral fractures with percutaneous vertebroplasty or kyphoplasty.  Osteoporos Int . 2001;  12 429-437
• 35 Liebschner M A, Rosenberg W S, Keaveny T M. Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty.  Spine . 2001;  26 1547-1554
• 36 Belkoff S M, Mathis J M, Jasper L E. The biomechanics of vertebroplasty. The effect of cement volume on mechanical behavior.  Spine . 2001;  26 1537-1541
• 37 O'Brien J, Sims J, Evans A. Vertebroplasty in patients with severe vertebral compression fractures: a technical report.  AJNR Am J Neuroradiol . 2000;  21 1373-1374
• 38 Tohmeh A G, Mathis J M, Fenton D C. Biomechanical efficacy of unipedicular versus bipedicular vertebroplasty for the management of osteoporotic compression fractures.  Spine . 1999;  24 1772-1776
• 39 Kaufmann T J, Jensen M E, Schweickert P A. Age of fracture and clinical outcomes of percutaneous vertebroplasty.  AJNR Am J Neuroradiol . 2001;  22 1860-1863
• 40 Minart D, Vallee J N, Cormier E. Percutaneous coaxial transpedicular biopsy of vertebral body lesions during vertebroplasty.  Neuroradiology . 2001;  43 409-412