PERCUTANEOUS VERTEBROPLASTY WITH POLYMETHYLMETHACRYLATE: Technique, Indications, and Results

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Polymethylmethacrylate (PMMA) is the principal component of bone cements used for rapid stable fixation of implants, such as metal and plastic prosthetics placed in living bone during orthopedic procedures. PMMA occasionally has been put into vertebral lesions during open surgical operations.22 Percutaneous vertebroplasty (PVP) with PMMA was invented by the authors in 1984.12 Treatment of aggressive vertebral angiomas (VA) was the first indication.7, 12 PVP with PMMA was then used for other lesions weakening the vertebral body, such as malignant tumors and osteoporotic vertebral collapse syndrome.1, 10, 11, 15, 16, 17 The aim of this percutaneous treatment is to obtain an analgesic effect by vertebral stabilization in patients complaining of back pain related to lesions weakening the spine. This article describes the technique, indications, results, and complications of PVP with PMMA.

Section snippets

Material

Vertebral percutaneous puncture is performed using needles of different lengths and diameters depending on the vertebral level (Fig. 1). At the cervical level we use 14- or 15-gauge needles, 7 cm long with a tapered or beveled end. At the thoracic or lumbar level, we use 10-gauge needles of 10 to 15 cm long with a beveled end. The bone cement is injected using 1 to 3 mL Luer-Lok syringes. A syringe handle makes the injection easier. The bone cement package consists of a two-component system:

INDICATIONS

PVP is indicated for the treatment of destabilizing and painful vertebral lesions. There are three major indications: (1) vertebral angiomas (VA), (2) osteoporotic vertebral collapse syndrome, and (3) malignant vertebral tumors.

INCIDENTS AND COMPLICATIONS

Incidents and complications can be related to the percutaneous approach, the status of the patient, and the injection of PMMA. Together with J. Chiras, we have published the incidents and complications concerning 274 patients with PVP.2, 3

ACKNOWLEDGMENT

We wish to thank Dr. Kieran Murphy for his assistance in this study.

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  • Cited by (0)

    Address reprint requests to Hervé Deramond, MD, Service de Radiologie A, Place Victor Pauchet, Centre Hospitalier Universitaire, Amiens 80054, France

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