Skip to main content
SpringerLink
Log in

Cement Consolidation: Vertebral Augmentation and Cementoplasty

  • Chapter
  • First Online:
Interventional Radiology in Palliative Care

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

  • 509 Accesses

Abstract

Structural bone instability from osteoporosis or tumor destruction can result in debilitating pain, fractures, and erosion of muscle attachments. Cementoplasty describes the percutaneous minimally invasive injection of a bone filler to consolidate the weakened bone in order to provide palliative effect and reduce the risk of an impending fracture or progression of an existing fracture. When applied to the spine, the technique is commonly known as vertebral augmentation, a term that encompasses both vertebroplasty and kyphoplasty. Outside of the spine, the procedure is commonly referred to as cementoplasty or osteoplasty, and sometimes with specific anatomical descriptors such as sarcoplasty and acetabuloplasty. This chapter reviews the indications, general techniques, and pitfalls for percutaneous cement stabilization both within and outside of the spine.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Abbreviations

CT:

computed tomography

HA:

Hydroxyapatite

MRI:

magnetic resonance imaging

PMMA:

Polymethyl methacrylate

References

  • Aebli N, Krebs J, Davis G et al (2002) Fat embolism and acute hypotension during vertebroplasty: an experimental study in sheep. Spine 27(5):460–466

    Article  PubMed  Google Scholar 

  • Ahmed M, Bjurholm A, Kreicbergs A et al (1993) Neuropeptide Y, tyrosine hydroxylase, and vasoactive intestinal polypeptide-immunoreactive nerve fibers in the vertebral bodies, discs, dura mater, and spinal ligaments of the rat lumbar spine. Spine 18:268–273

    Article  CAS  PubMed  Google Scholar 

  • Anselmetti GC (2010) Osteoplasty: percutaneous bone cement injection beyond the spine. Semin Intervent Radiol 27(2):199–208

    Article  PubMed  PubMed Central  Google Scholar 

  • Anselmetti GC, Manca A, Ortega C et al (2008) Treatment of extraspinal painful bone metastases with percutaneous cementoplasty: a prospective study of 50 patients. Cardiovasc Interv Radiol 31:1165–1173

    Article  Google Scholar 

  • Anselmetti GC, Manca A, Kanika K, Murphy K, Eminefendic H, Masala S et al (2009) Temperature measurement during polymerization of bone cement in percutaneous vertebroplasty: an in vivo study in humans. Cardiovasc Intervent Radiol 32:491–498

    Article  PubMed  Google Scholar 

  • Anselmetti GC, Marcia S, Saba L et al (2012) Percutaneous vertebroplasty: multi-centric results from EVEREST experience in large cohort of patients. Eur J Radiol 81(12):4083–4086

    Article  PubMed  Google Scholar 

  • Anselmetti GC, Manca A, Tutton S, Chiara G, Kelekis A, Facchini FR, Russo F, Regge D, Montemurro F (2013) Percutaneous vertebral augmentation assisted by PEEK implant in painful osteolytic vertebral metastasis involving the vertebral well: experience on 40 patients. Pain Physician 16(4):E397–E404

    Article  PubMed  Google Scholar 

  • Barragan-Campos HM, Vallee JN, Daouda L et al (2006) Percutaneous vertebroplasty for spinal metastases: complications. Radiology 238(1):354–362

    Article  PubMed  Google Scholar 

  • Berenson J, Pflugmacher R, Jarzem P et al (2011) Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer: a multicenter, randomized controlled trial. Lancet Oncol 12:225–235

    Article  PubMed  Google Scholar 

  • Cazzato RL, Koch G, Buy X, Ramamurthy N, Tsoumakidou G, Caudrelier J, Catena V, Garnon J, Palussiere J, Gangi A (2016) Percutaneous image-guided screw fixation of bone lesions in cancer patients: double-centre analysis of outcomes including local evolution of the treated focus. Cardiovasc Intervent Radiol 39(10):1455–1463

    Article  PubMed  Google Scholar 

  • Chung SE, Lee SH, Kim TH et al (2005) Renal cement embolism during percutaneous vertebroplasty. Eur Spine J 14:1–5

    Google Scholar 

  • Collinge CA, Crist BD (2016) Combined percutaneous iliosacral screw fixation with sacroplasty using resorbable calcium phosphate cement for osteoporotic pelvic fractures requiring surgery. J Orthop Trauma 30(6):e217–e222

    PubMed  Google Scholar 

  • David E, Kaduri S, Yee A, Chow E, Sahgal A, Chan S, Hanna R (2017) Initial single center experience: radiofrequency assisted vertebroplasty and osteoplasty using a bipolar device in the palliation of bone metastases. Ann Palliat Med 6(2):118–124

    Article  PubMed  Google Scholar 

  • Deschamps F, De Baere T (2012) Cementoplasty of bone metastases. Diagn Intervent Imaging 93(9):685–689

    Article  CAS  Google Scholar 

  • Deschamps F, Farouil G, Hakime A, Teriitehau C, Barah A, de Baere T (2012) Percutaneous stabilization of impending pathological fracture of the proximal femur. Cardiovasc Intervent Radiol 35(6):1428–1432

    Article  PubMed  Google Scholar 

  • Deschamps F, de Baere T, Hakime A et al (2016) Percutaneous osteosynthesis in the pelvis in cancer patients. Eur Radiol 26(6):1631–1639

    Article  PubMed  Google Scholar 

  • Deschamps F, Yevich S, Gravel G et al (2018) Percutaneous fixation by internal cemented screw for the treatment of unstable osseous disease in cancer patients. Semin Intervent Radiol 35(4):238–247

    Article  PubMed  PubMed Central  Google Scholar 

  • Figura N, Smith J, Hsiang-Hsuan MY (2018) Mechanisms of, and adjuvants for, bone pain. Hematol Oncol Clin North Am 32(3):447–458

    Article  PubMed  Google Scholar 

  • Filippiadis DK, Marcia S, Masala S, Deschamps F, Kelekis A (2017) Percutaneous vertebroplasty and kyphoplasty: current status, new developments and old controversies. Cardiovasc Intervent Radiol 40(12):1815–1823

    Article  PubMed  Google Scholar 

  • Gangi A, Guth S, Imbert JP et al (2003) Percutaneous vertebroplasty: indications, technique, and results. Radiographics 23(2):e10

    Article  PubMed  Google Scholar 

  • Hartung MP, Tutton SM, Hohenwalter EJ et al (2016) Safety and efficacy of minimally invasive acetabular stabilization for preiacetabular metastatic disease with thermal ablation and augmented screw fixation. J Vasc Interv Radiol 27:682–688

    Article  PubMed  Google Scholar 

  • Heini PF, Orler R (2004) Vertebroplasty in severe osteoporosis. Technique and experience with multi-segment injection. Orthopade 33(1):22–30

    Article  CAS  PubMed  Google Scholar 

  • Hildalgo JA, Reddy CG, Schmit GD, Spinner RJ (2012) Sciatic neuropathy after extruded cement from cementoplasty. Spine J 12:532–533

    Article  Google Scholar 

  • Kim SY, Seo JB, Do KH et al (2005) Cardiac perforation caused by acrylic cement: a rare complication of percutaneous vertebroplasty. AJR Am J Roentgenol 185(5):1245–1247

    Article  PubMed  Google Scholar 

  • Kurashina K, Kurita H, Hirano M et al (1995) Calcium phosphate cement: in vitro and in vivo studies of the α-tricalcium phosphate-dicalcium phosphate dibasic-tetracalcium phosphate monoxide system. J Mater Sci Mater Med 6:340–347

    Article  CAS  Google Scholar 

  • Lee CH, Lee JW, Hyun SJ et al (2014) Needle-tract seeding after percutaneous vertebroplasty: a case report. Spine 39(12):E752–E756

    Article  PubMed  Google Scholar 

  • Lin EP, Ekholm S, Hiwatashi A et al (2004) Vertebroplasty: cement leakage into the disc increase the risk of new fracture of adjacent vertebral body. Am J Neuroradiol 25:175–180

    PubMed  PubMed Central  Google Scholar 

  • Mirovsky Y, Anekstein Y, Shalmon E et al (2006) Intradiscal cement leak following percutaneous vertebroplasty. Spine 31(10):1120–1124

    Article  PubMed  Google Scholar 

  • Monticelli F, Meyer HJ, Tutsch-Bauer E (2005) Fatal pulmonary cement embolism following percutaneous vertebroplasty (PVP). Forensic Sci Int 149:35–38

    Article  CAS  PubMed  Google Scholar 

  • Mundy GR (1997) Mechanisms of bone metastasis. Cancer 80:1546–1556

    Article  CAS  PubMed  Google Scholar 

  • Munk PL, Rashid F, Heran MK et al (2009) Combined cementoplasty and radiofrequency ablation in the treatment of painful neoplastic lesions of bone. J Vasc Interv Radiol 20:903–911

    Article  PubMed  Google Scholar 

  • Nakatsuka A, Yamakado K (2004) Maeda et al. radiofrequency ablation combined with bone cement injection for the treatment of bone malignancies. J Vasc Interv Radiol 15:707–712

    Article  PubMed  Google Scholar 

  • Noriega D, Maestretti G, Renaud C et al (2015) Clinical performance and safety of 108 SpineJack implantations: 1-year results of a prospective multicentre single-arm registry study. Biomed Res Int 2015:173872

    Article  PubMed  PubMed Central  Google Scholar 

  • Padovani B, Kasriel O, Brunner P, Peretti-Viton P (1999) Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty. Am J Neuroradiol 20:375–377

    CAS  PubMed  PubMed Central  Google Scholar 

  • Pitton MB, Herber S, Koch U et al (2008) CT-guided vertebroplasty: analysis of technical results, extraosseous cement leakages, and complications in 500 procedures. Eur Radiol 18:2568–2578

    Article  PubMed  Google Scholar 

  • Pron G, Holubowich C, Kaulback K (2016) Vertebral augmentation involving vertebroplasty or kyphoplasty for cancer-related vertebral compression fractures: a systematic review. Ont Health Technol Assess Ser 16(11):1–202

    PubMed Central  Google Scholar 

  • Saad F, Lipton A, Cook R, Chen YM et al (2007) Pathologic fractures correlate with reduced survival in patients with malignant bone disease. Cancer 110(8):1860–1867

    Article  PubMed  Google Scholar 

  • Santiago FR, Chinchilla AS, Alvarez LG et al (2014) Comparative review of vertebroplasty and kyphoplasty. World J Radiol 6(6):329–343

    Article  Google Scholar 

  • Sun G, Jin P, Xun-wei L et al (2014) Cementoplasty for managing painful bone metastases outside the spine. Eur Radiol 24:731–737

    Article  PubMed  Google Scholar 

  • Tian QH, He CJ, Wu CG et al (2016) Comparison of percutaneous cementoplasty with and without interventional internal fixation for impending malignant pathological fracture of the proximal femur. Cardiovasc Intervent Radiol 39(1):81–89

    Article  PubMed  Google Scholar 

  • Tozzi P, Abdelmoumene Y, Corno AF et al (2002) Management of pulmonary embolism during acrylic vertebroplasty. Ann Thorac Surg 74:1706–1708

    Article  PubMed  Google Scholar 

  • Uransilp N, Muengtaweepongsa S, Chanalithichai N, Tammachote N (2018) Fat embolism syndrome: a case report and review of literature. Case Rep Med 2018:1479850

    PubMed  PubMed Central  Google Scholar 

  • Urrutia J, Bono CM, Mery P, Rojas C (2008) Early histologic changes following PMMA injection (vertebroplasty) in rabbit lumbar vertebrae. Spine 33(8):877–882

    Article  PubMed  Google Scholar 

  • Venmans A, Klazen C, Lohle P et al (2010) Percutaneous vertebroplasty and pulmonary cement embolism: results from VERTOS II. Am J Neuroradiol 31(8):1451–1453

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Wallace AN, Greenwood TJ, Jennings JW (2015) Radiofrequency ablation and vertebral augmentation for palliation of painful spinal metastases. J Neurooncol. 124:111–118

    Article  PubMed  Google Scholar 

  • Wang Z, Zhen Y, Wu C et al (2012) CT fluoroscopy-guided percutaneous osteoplasty for the treatment of osteolytic lung cancer bone metastases to the spine and pelvis. J Vasc Interv Radiol 23(9):1135–1142

    Article  PubMed  Google Scholar 

  • Yevich S, Tselikas L, Gravel G et al (2018) Percutaneous cement injection for the palliative treatment of osseous metastases: a technical review. Semin Intervent Radiol 35(4):268–280

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Diagnostic Imaging, Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Steven Yevich

Authors
  1. Steven Yevich
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Steven Yevich .

Editor information

Editors and Affiliations

  1. Vancouver General Hospital, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada

    Peter L. Munk

  2. Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Yishun Central, Singapore, Singapore

    Suresh B Babu

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Yevich, S. (2021). Cement Consolidation: Vertebral Augmentation and Cementoplasty. In: Munk, P.L., Babu, S.B. (eds) Interventional Radiology in Palliative Care. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/978-3-030-65463-4_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-65463-4_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-65462-7

  • Online ISBN: 978-3-030-65463-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation