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Precutaneous
Vertebroplasty
Acrylic
cements have been used for the augmentation of weakened or partially
destroyed bones for decades. The term vertebroplasty originally described
an open surgical procedure that introduces bone graft or acrylic cement
to mechanically augment weakened vertebral bodies. Polymethylinethacrylate
(PMMA) is the acrylic most commonly used as a bone filler, and its application
in the treatment of pathologic vertebral compression fractures Vertebral
Compression Fracture(s) has been reported extensively. In particular,
it has been used to treat Vertebral Compression Fracture(s) created
by metastatic disease and primary bone tumors, such as aggressive bemangiomas
and giant cell tumors.
The first image-guided percutaneous vertebral augmentation, or percutaneous
vertebroplasty (PVP), was performed in France in 1984, when Deramond
and Galibert injected PMMA into a C2 vertebra that had been partially
destroyed by an aggressive hemangioma. The procedure relieved the patient's
long-term pain. Shortly thereafter, PVP was used to treat Vertebral
Compression Fracture(s) caused by osteoporosis.
The interest in PVP has continued to grow since its introduction in
Europe and its subsequent introduction in the United States by the interventional
neuroradiology team at the University of Virginia. PVP reportedly offers
the patient rapid relief from the pain associated with Vertebral Compression
Fracture(s) and is evolving as a standard of care for Vertebral Compression
Fracture(s). In this review, we describe patient selection criteria,
technical aspects of the procedure, and potential complications; review
some of the basic science and biomechanics research related to the procedure.