Percutaneous vertebroplasty is indicated primarily for the reduction of pain related to vertebral compression fractures. Most of the treated patients suffered from pathologic fractures related to osteoporosis. Review detailed information about indications and contraindications.
Because of the frequency of multiple fractures in this population of patients, careful clinical and imaging correlation is required to determine the etiology and level of the patient's pain. Findings on plain radiographs and MRI, particularly MR demonstration of edema within a fractured vertebral body, should correlate with the level of tenderness upon palpation of the spinous processes. MRI stir sequences are most useful for the depiction of edema. A bone scan showing activity in the fracture is helpful for confirming the more recent fracture in a patient with multiple fractures over an extended period.
Vertebroplasty should be performed under high quality imaging equipment such as an angio suite; digital imaging is superior to analog. Bi-plane imaging facilitates the procedure, but is not required. Portable C-arm units are acceptable; please note that some earlier versions of portable C-arms do not provide adequate imaging for safe injection of opacified cement. You should always check visibility of cement using your equipment prior to scheduling an initial procedure.
Percutaneous vertebroplasty can be performed in the operating room using a high quality portable C-arm as described above. General anesthesia is not necessary, and therefore the operating room forum or surgical center are both appropriate.
