Percutaneous Vertebroplasty: Overview, Indications, Contraindications

Overview Vertebroplasty is an image-guided therapy in which a cement, a fast-setting polymer, is injected into a pathologic vertebral body. The purpose of this procedure is to relieve pain and disability. It can be used in the setting of painful osteoporotic compression fract...

Illustration of thoracic vertebrae showing vertebral body, pedicles, facets, transverse process, rib joints, spinous process, and lamina. The lumbar spine is the next segment of the spine and is more mobile than the thoracic. The lumbar spine typically consists of 5 large ...

Lumbar vertebrae are characterized by massive bodies and robust spinous and transverse processes. Their articular facets are oriented somewhat parasagittally, which is thought to contribute the large range of anteroposterior bending possible between lumbar vertebrae. Lumbar vertebrae also contain ...

Indications Indications for percutaneous vertebroplasty include painful, non-healing osteoporotic or neoplastic vertebral compression fractures refractory to medical therapy. When these conditions result in loss of normal vertebral body height, balloon kyphoplasty or vertebr...

Contraindications Absolute contraindications: [15] Fractures that are asymptomatic Active osteomyelitis of the target vertebra Coagulopathy that is not amenable to correc...

Technique Equipment Multiple vertebroplasty kits are available. Each manufacturer has their own specific subsets with unique names for the devices, but the basic components are the same: access needle, syringe, cement, and cement mixing apparatus. See individual manufa...

Percutaneous vertebroplasty, transpedicular approach. ...

Percutaneous vertebroplasty, transpedicular approach under fluoroscopic guidance, lateral view. ...

Percutaneous vertebroplasty, transpedicular approach under fluoroscopic guidance, anteroposterior view. Transpedicular approaches: For a unipedicular approach, advance needle into the anterior third of the central vertebral body. ...

Complications Complications with percutaneous vertebroplasty are more commonly seen with malignant spinal tumors and hemangiomas than with osteoporotic compression fractures. Chiras et al reported incidents and complications in 274 patients with 10% attributable to spinal tumo...

Questions & Answers Galibert P, Deramond H, Rosat P, Le Gars D. [Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty]. Neurochirurgie...

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Author Gaurav Gupta, MD, FAANS, FACS Associate Professor of Neurosurgery, System Co-Director, Cerebrovascular and Endovascular Neurosurgery, Fellowship Director, Endovascular Neurosurgery Fellowship (Site), Department of Surgery, Division of Neurosurgery, Rutgers RWJ Barnabas Healthcare...

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