Download PDF
Semin intervent Radiol 2013; 30(03): 297-306
DOI: 10.1055/s-0033-1353483
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Vertebroplasty

Bryan Jay
1   Division of Interventional Radiology, Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, Rhode Island
,
Sun Ho Ahn
1   Division of Interventional Radiology, Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, Rhode Island
› Author Affiliations
Further Information

Publication History

Publication Date:
13 September 2013 (online)

Also available at
    Permissions and Reprints

Abstract

Percutaneous vertebroplasty has become widely accepted as a safe and effective minimally invasive procedure for the treatment of painful vertebral body compression fractures refractory to medical therapy. In this article, the authors review the indications and contraindications for vertebroplasty, principles of appropriate patient selection, useful techniques to achieve optimal outcomes, and the potential risks and complications of the procedure.

Keywords

vertebral compression fracture - osteoporosis - vertebroplasty - kyphoplasty - vertebral augmentation - interventional radiology
 

  • References

  • 1 Leech JA, Dulberg C, Kellie S, Pattee L, Gay J. Relationship of lung function to severity of osteoporosis in women. Am Rev Respir Dis 1990; 141 (1) 68-71
    CrossrefPubMedGoogle Scholar
  • 2 Borgström F, Zethraeus N, Johnell O , et al. Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int 2006; 17 (5) 637-650
    CrossrefPubMedGoogle Scholar
  • 3 Silverman SL. The clinical consequences of vertebral compression fracture. Bone 1992; 13 (Suppl. 02) S27-S31
    CrossrefPubMedGoogle Scholar
  • 4 Röllinghoff M, Zarghooni K, Schlüter-Brust K , et al. Indications and contraindications for vertebroplasty and kyphoplasty. Arch Orthop Trauma Surg 2010; 130 (6) 765-774
    CrossrefPubMedGoogle Scholar
  • 5 Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR ; Study of Osteoporotic Fractures Research Group. Vertebral fractures and mortality in older women: a prospective study. Arch Intern Med 1999; 159 (11) 1215-1220
    Google Scholar
  • 6 Nevitt MC, Thompson DE, Black DM , et al; Fracture Intervention Trial Research Group. Effect of alendronate on limited-activity days and bed-disability days caused by back pain in postmenopausal women with existing vertebral fractures. Arch Intern Med 2000; 160 (1) 77-85
    CrossrefPubMedGoogle Scholar
  • 7 Riggs BL, Melton III LJ. The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 1995; 17 (5, Suppl): 505S-511S
    CrossrefPubMedGoogle Scholar
  • 8 Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 2006; 17 (12) 1726-1733
    CrossrefPubMedGoogle Scholar
  • 9 Lips P. Epidemiology and predictors of fractures associated with osteoporosis. Am J Med 1997; 103 (2A) 3S-8S , discussion 8S–11S
    PubMedGoogle Scholar
  • 10 Klazen CA, Verhaar HJ, Lohle PN , et al. Clinical course of pain in acute osteoporotic vertebral compression fractures. J Vasc Interv Radiol 2010; 21 (9) 1405-1409
    CrossrefPubMedGoogle Scholar
  • 11 Galibert P, Deramond H, Rosat P, Le Gars D. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty [in French]. Neurochirurgie 1987; 33 (2) 166-168
    PubMedGoogle Scholar
  • 12 Gangi A, Sabharwal T, Irani FG, Buy X, Morales JP, Adam A ; Standards of Practice Committee of the Society of Interventional Radiology. Quality assurance guidelines for percutaneous vertebroplasty. Cardiovasc Intervent Radiol 2006; 29 (2) 173-178
    CrossrefPubMedGoogle Scholar
  • 13 Garfin SR, Yuan HA, Reiley MA. New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine 2001; 26 (14) 1511-1515
    Google Scholar
  • 14 McGraw JK, Cardella J, Barr JD , et al; Society of Interventional Radiology Standards of Practice Committee. Society of Interventional Radiology quality improvement guidelines for percutaneous vertebroplasty. J Vasc Interv Radiol 2003; 14 (9, Pt 2) S311-S315
    CrossrefPubMedGoogle Scholar
  • 15 Cortet B, Cotten A, Boutry N , et al. Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study. J Rheumatol 1999; 26 (10) 2222-2228
    Google Scholar
  • 16 Cotten A, Boutry N, Cortet B , et al. Percutaneous vertebroplasty: state of the art. Radiographics 1998; 18 (2) 311-320 , discussion 320–323
    PubMedGoogle Scholar
  • 17 Cyteval C, Sarrabère MP, Roux JO , et al. Acute osteoporotic vertebral collapse: open study on percutaneous injection of acrylic surgical cement in 20 patients. AJR Am J Roentgenol 1999; 173 (6) 1685-1690
    CrossrefPubMedGoogle Scholar
  • 18 Deramond H, Depriester C, Galibert P, Le Gars D. Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. Radiol Clin North Am 1998; 36 (3) 533-546
    CrossrefPubMedGoogle Scholar
  • 19 Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion JE. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol 1997; 18 (10) 1897-1904
    PubMedGoogle Scholar
  • 20 Mathis JM, Petri M, Naff N. Percutaneous vertebroplasty treatment of steroid-induced osteoporotic compression fractures. Arthritis Rheum 1998; 41 (1) 171-175
    CrossrefPubMedGoogle Scholar
  • 21 Cotten A, Dewatre F, Cortet B , et al. Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up. Radiology 1996; 200 (2) 525-530
    CrossrefPubMedGoogle Scholar
  • 22 Weill A, Chiras J, Simon JM, Rose M, Sola-Martinez T, Enkaoua E. Spinal metastases: indications for and results of percutaneous injection of acrylic surgical cement. Radiology 1996; 199 (1) 241-247
    PubMedGoogle Scholar
  • 23 McDonald RJ, Trout AT, Gray LA, Dispenzieri A, Thielen KR, Kallmes DF. Vertebroplasty in multiple myeloma: outcomes in a large patient series. AJNR Am J Neuroradiol 2008; 29 (4) 642-648
    CrossrefPubMedGoogle Scholar
  • 24 Pflugmacher R, Schleicher P, Schröder RJ, Melcher I, Klostermann CK. Maintained pain reduction in five patients with multiple myeloma 12 months after treatment of the involved cervical vertebrae with vertebroplasty. Acta Radiol 2006; 47 (8) 823-829
    CrossrefPubMedGoogle Scholar
  • 25 Deramond H, Darrasson R, Galibert P. Percutaneous vertebroplasty with acrylic cement in the treatment of aggressive spinal angiomas. Rachis 1989; 1: 143-153
    PubMedGoogle Scholar
  • 26 Acosta Jr FL, Sanai N, Chi JH , et al. Comprehensive management of symptomatic and aggressive vertebral hemangiomas. Neurosurg Clin N Am 2008; 19 (1) 17-29
    CrossrefPubMedGoogle Scholar
  • 27 Cotten A, Deramond H, Cortet B , et al. Preoperative percutaneous injection of methyl methacrylate and N-butyl cyanoacrylate in vertebral hemangiomas. AJNR Am J Neuroradiol 1996; 17 (1) 137-142
    PubMedGoogle Scholar
  • 28 Feydy A, Cognard C, Miaux Y , et al. Acrylic vertebroplasty in symptomatic cervical vertebral haemangiomas: report of 2 cases. Neuroradiology 1996; 38 (4) 389-391
    CrossrefPubMedGoogle Scholar
  • 29 Ide C, Gangi A, Rimmelin A , et al. Vertebral haemangiomas with spinal cord compression: the place of preoperative percutaneous vertebroplasty with methyl methacrylate. Neuroradiology 1996; 38 (6) 585-589
    CrossrefPubMedGoogle Scholar
  • 30 Zapałowicz K, Radek A, Błaszczyk B, Koziński T, Zelechowski J. Percutaneous vertebroplasty with methyl methacrylate bone cement in the treatment of spinal angiomas and neoplasms. Ortop Traumatol Rehabil 2003; 5 (2) 185-188
    PubMedGoogle Scholar
  • 31 Cardon T, Hachulla E, Flipo RM , et al. Percutaneous vertebroplasty with acrylic cement in the treatment of a Langerhans cell vertebral histiocytosis. Clin Rheumatol 1994; 13 (3) 518-521
    CrossrefPubMedGoogle Scholar
  • 32 Masala S, Pipitone V, Tomassini M, Massari F, Romagnoli A, Simonetti G. Percutaneous vertebroplasty in painful Schmorl nodes. Cardiovasc Intervent Radiol 2006; 29 (1) 97-101
    CrossrefPubMedGoogle Scholar
  • 33 Nieuwenhuijse MJ, van Erkel AR, Dijkstra PD. Percutaneous vertebroplasty in very severe osteoporotic vertebral compression fractures: feasible and beneficial. J Vasc Interv Radiol 2011; 22 (7) 1017-1023
    CrossrefPubMedGoogle Scholar
  • 34 Rad AE, Kallmes DF. Pain relief following vertebroplasty in patients with and without localizing tenderness on palpation. AJNR Am J Neuroradiol 2008; 29 (9) 1622-1626
    CrossrefPubMedGoogle Scholar
  • 35 Beall DP, Datir A, D'Souza SL , et al. Percutaneous treatment of insufficiency fractures : principles, technique and review of literature. Skeletal Radiol 2010; 39 (2) 117-130
    CrossrefPubMedGoogle Scholar
  • 36 Beall DP, Braswell JJ, Martin HD, Stapp AM, Puckett TA, Stechison MT. Technical strategies and anatomic considerations for parapedicular access to thoracic and lumbar vertebral bodies. Skeletal Radiol 2007; 36 (1) 47-52
    CrossrefPubMedGoogle Scholar
  • 37 Katsanos K, Sabharwal T, Adam A. Percutaneous cementoplasty. Semin Intervent Radiol 2010; 27 (2) 137-147
    Article in Thieme ConnectPubMedGoogle Scholar
  • 38 Peh WC, Munk PL, Rashid F, Gilula LA. Percutaneous vertebral augmentation: vertebroplasty, kyphoplasty and skyphoplasty. Radiol Clin North Am 2008; 46 (3) 611-635 , vii
    CrossrefPubMedGoogle Scholar
  • 39 Gaughen JR, Jensen ME, Schweickert PA , et al. Relevance of antecedent venography in percutaneous vertebroplasty for the treatment of osteoporotic compression fractures. Amer J Neuroradil 2002; 23 (4) 594-600
    PubMedGoogle Scholar
  • 40 Kallmes DF, Jensen ME. Percutaneous vertebroplasty. Radiology 2003; 229 (1) 27-36
    CrossrefPubMedGoogle Scholar
  • 41 Belkoff SM, Mathis JM, Jasper LE, Deramond H. The biomechanics of vertebroplasty. The effect of cement volume on mechanical behavior. Spine 2001; 26 (14) 1537-1541
    CrossrefPubMedGoogle Scholar
  • 42 Al-Ali F, Barrow T, Luke K. Vertebroplasty: what is important and what is not. AJNR Am J Neuroradiol 2009; 30 (10) 1835-1839
    CrossrefPubMedGoogle Scholar
  • 43 Boszczyk B. Volume matters: a review of procedural details of two randomised controlled vertebroplasty trials of 2009. Eur Spine J 2010; 19 (11) 1837-1840
    CrossrefPubMedGoogle Scholar
  • 44 Kim AK, Jensen ME, Dion JE, Schweickert PA, Kaufmann TJ, Kallmes DF. Unilateral transpedicular percutaneous vertebroplasty: initial experience. Radiology 2002; 222 (3) 737-741
    CrossrefPubMedGoogle Scholar
  • 45 Hochmuth K, Proschek D, Schwarz W, Mack M, Kurth AA, Vogl TJ. Percutaneous vertebroplasty in the therapy of osteoporotic vertebral compression fractures: a critical review. Eur Radiol 2006; 16 (5) 998-1004
    CrossrefPubMedGoogle Scholar
  • 46 McGraw JK, Cardella J, Barr JD , et al; SIR Standards of Practice Committee. Society of Interventional Radiology quality improvement guidelines for percutaneous vertebroplasty. J Vasc Interv Radiol 2003; 14 (7) 827-831
    CrossrefPubMedGoogle Scholar
  • 47 Chiras J, Depriester C, Weill A, Sola-Martinez MT, Deramond H. Percutaneous vertebral surgery. Technics and indications [in French]. J Neuroradiol 1997; 24 (1) 45-59
    PubMedGoogle Scholar
  • 48 Vallejo R, Benyamin R. Vertebral augmentation techniques for the treatment of vertebral compression fractures: a review. Reg Anesth Pain Manag 2010; 14 (3) 133-141
    PubMedGoogle Scholar
  • 49 Hulme PA, Krebs J, Ferguson SJ, Berlemann U. Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine 2006; 31 (17) 1983-2001
    CrossrefPubMedGoogle Scholar
  • 50 Berenson J, Pflugmacher R, Jarzem P , et al; Cancer Patient Fracture Evaluation (CAFE) Investigators. Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer: a multicentre, randomised controlled trial. Lancet Oncol 2011; 12 (3) 225-235
    CrossrefPubMedGoogle Scholar
  • 51 Grafe IA, Da Fonseca K, Hillmeier J , et al. Reduction of pain and fracture incidence after kyphoplasty: 1-year outcomes of a prospective controlled trial of patients with primary osteoporosis. Osteoporos Int 2005; 16 (12) 2005-2012
    CrossrefPubMedGoogle Scholar
  • 52 Hadjipavlou AG, Tzermiadianos MN, Katonis PG, Szpalski M. Percutaneous vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures and osteolytic tumours. J Bone Joint Surg Br 2005; 87 (12) 1595-1604
    PubMedGoogle Scholar
  • 53 Kasperk C, Hillmeier J, Nöldge G , et al. Treatment of painful vertebral fractures by kyphoplasty in patients with primary osteoporosis: a prospective nonrandomized controlled study. J Bone Miner Res 2005; 20 (4) 604-612
    PubMedGoogle Scholar
  • 54 Komp M, Ruetten S, Godolias G. Minimally invasive therapy for functionally unstable osteoporotic vertebral fracture by means of kyphoplasty: prospective comparative study of 19 surgically and 17 conservatively treated patients. J Miner Stoffwechs 2004; 11 (Suppl. 01) 13-15
    PubMedGoogle Scholar
  • 55 Ploeg WT, Veldhuizen AG, The B, Sietsma MS. Percutaneous vertebroplasty as a treatment for osteoporotic vertebral compression fractures: a systematic review. Eur Spine J 2006; 15 (12) 1749-1758
    CrossrefPubMedGoogle Scholar
  • 56 Taylor RS, Fritzell P, Taylor RJ. Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis. Eur Spine J 2007; 16 (8) 1085-1100
    CrossrefPubMedGoogle Scholar
  • 57 Bouza C, López T, Magro A, Navalpotro L, Amate JM. Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review. Eur Spine J 2006; 15 (7) 1050-1067
    CrossrefPubMedGoogle Scholar
  • 58 Voormolen MH, Mali WP, Lohle PN , et al. Percutaneous vertebroplasty compared with optimal pain medication treatment: short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures. The VERTOS study. AJNR Am J Neuroradiol 2007; 28 (3) 555-560
    PubMedGoogle Scholar
  • 59 Wardlaw D, Cummings SR, Van Meirhaeghe J , et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet 2009; 373 (9668) 1016-1024
    CrossrefPubMedGoogle Scholar
  • 60 Kallmes DF, Comstock BA, Heagerty PJ , et al. A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 2009; 361 (6) 569-579
    CrossrefPubMedGoogle Scholar
  • 61 Buchbinder R, Osborne RH, Ebeling PR , et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 2009; 361 (6) 557-568
    CrossrefPubMedGoogle Scholar
  • 62 Klazen CA, Lohle PN, de Vries J , et al. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet 2010; 376 (9746) 1085-1092
    CrossrefPubMedGoogle Scholar
  • 63 Firanescu C, Lohle PN, de Vries J , et al; VERTOS IV study group. A randomised sham controlled trial of vertebroplasty for painful acute osteoporotic vertebral fractures (VERTOS IV). Trials 2011; 12: 93
    CrossrefPubMedGoogle Scholar