Percutaneous vertebroplasty: indications, technique, and results.

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.

[1]  A. Gangi,et al.  Interventional radiology with laser in bone and joint. , 1998, Radiologic clinics of North America.

[2]  J. Hebel,et al.  Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. , 2002, Journal of vascular and interventional radiology : JVIR.

[3]  A. Gangi,et al.  Vertebral haemangiomas with spinal cord compression: the place of preoperative percutaneous vertebroplasty with methyl methacrylate , 1996, Neuroradiology.

[4]  H. Deramond,et al.  [Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty]. , 1987, Neuro-Chirurgie.

[5]  A. Gangi,et al.  Interventional Radiology Guided by a Combination of Computed Tomography and Fluoroscopy: Technique, Indications, and Advantages , 1995 .

[6]  O. S. Nielsen,et al.  Bone metastases: pathophysiology and management policy. , 1991, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[7]  L. Gilula,et al.  Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. , 2002, Radiology.

[8]  H. Deramond,et al.  Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. , 1998, Radiologic clinics of North America.

[9]  X Demondion,et al.  Percutaneous vertebroplasty: state of the art. , 1998, Radiographics : a review publication of the Radiological Society of North America, Inc.

[10]  A. Gangi,et al.  Computed Tomography (CT) and Flouroscopy-guided Vertebroplasty: Results and Complications in 187 Patients , 1999 .

[11]  A. Gangi,et al.  Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. , 1994, AJNR. American journal of neuroradiology.

[12]  D. Tong,et al.  The palliation of symptomatic osseous metastases final results of the study by the radiation therapy oncology group , 1982, Cancer.

[13]  D. Renfrew,et al.  CT-guided percutaneous transpedicular biopsy of the spine. , 1991, Radiology.

[14]  B. Ghelman,et al.  Biopsies of the musculoskeletal system. , 1998, Radiologic clinics of North America.

[15]  S. Lavine,et al.  Percutaneous Transpedicular Polymethylmethacrylate Vertebroplasty for the Treatment of Spinal Compression Fractures , 2001, Neurosurgery.

[16]  R. Assaker,et al.  Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up. , 1996, Radiology.

[17]  A. Gangi,et al.  Interventional radiologic procedures with CT guidance in cancer pain management. , 1996, Radiographics : a review publication of the Radiological Society of North America, Inc.

[18]  H. Deramond,et al.  Percutaneous vertebroplasty in benign and malignant disease. , 2000 .

[19]  J. Barr,et al.  Percutaneous Vertebroplasty for Pain Relief and Spinal Stabilization , 2000, Spine.

[20]  F. Mornex,et al.  Vertébroplastie percutanée dans le traitement des métastases: technique et résultats , 1989 .

[21]  A. Gangi,et al.  Injection of Alcohol into Bone Metastases under CT Guidance , 1994, Journal of computer assisted tomography.

[22]  F. Grados,et al.  Long‐term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty , 2000 .

[23]  Y. Ito,et al.  Gene expression during osteoclast-like cell formation induced by antifusion regulatory protein-1/CD98/4F2 monoclonal antibodies (MAbs): c-src is selectively induced by anti-FRP-1 MAb. , 1999, Bone.

[24]  S. Belkoff,et al.  The Biomechanics of Vertebroplasty: The Effect of Cement Volume on Mechanical Behavior , 2001, Spine.