Vertebroplasty in Osteoporosis

ABSTRACT

Percutaneous vertebroplasty (PV) is a safe and effective treatment for relieving pain in patients complaining of severe back pain induced by osteoporotic compression fractures. The success rate exceeds 90% and the complication rate is lower than 1%. Most of the complications are transient and should be avoided using good technique. The classic indication for PV is severe, persistent, and incapacitating focal back pain not responding to standard medical therapy and related to one or more collapsed vertebral bodies of 4 to 12 weeks duration. PV should be used earlier in patients at risk of immobilization complications and requiring narcotics. PV should be always considered as a good alternative treatment compared with medical therapy in patients with pain and osteoporotic compression fractures.

KEYWORD

Spine - osteoporosis - interventional radiology - vertebroplasty

REFERENCES

• 1 Silverman S L. The clinical consequences of vertebral compression fracture.  Bone . 1992;  13(Suppl) S27-S31
• 2 Melton III J L. Epidemiology of spinal osteoporosis.  Spine . 1997;  22(Suppl) S2-S11
• 3 Cooper C, Atkinson E J, Jacobsen S T, O'Fallon W M, Melton III J L. Population-based study of survival after osteoporotic fractures.  Am J Epidemiol . 1993;  137 1001-1005
• 4 Rapado A. General management of vertebral fractures.  Bone . 1996;  18(Suppl) 191S-196S
• 5 Galibert P, Deramond H, Rosat P, Le Gars D. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty.  Neurochirurgie . 1987;  33 166-168
• 6 Lapras C, Mottolese C, Deruty R. Percutaneous injection of methyl metacrylate in the treatment of severe vertebral osteoporosis and osteolysis.  Ann Chir . 1989;  43 371-376
• 7 Debussche-Depriester, Deramond H, Fardellone P. Percutaneous vertebroplasty with acrylic cement in the treatment of osteoporotic vertebral crush fracture syndrome.  Neuroradiology . 1991;  33(Suppl) 149-152
• 8 Jensen M E, Evans A J, Mathis J M. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects.  AJNR Am J Neuroradiol . 1997;  18 897-1904
• 9 Mathis J M, Barr J D, Belkoff S M. Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures.  AJNR Am J Neuroradiol . 2001;  22 373-381
• 10 Stallmeyer M JB, Zoarski G H. Patient evaluation and selection. In: Mathis JM, Deramond H, Belkoff SM, eds. Percutaneous 2002 41-: 60
• 11 Kaufmann T J, Jensen M E, Schweickert P A, Marx W F, Kallmes D F. Age of fracture and clinical outcomes of percutaneous vertebroplasty.  AJNR Am J Neuroradiol . 2001;  22 1860-1863
• 12 Do H M. Magnetic resonance imaging in the evaluation of patients for percutaneous vertebroplasty.  Top Magn Reson Imaging . 2000;  11 235-244
• 13 Maynard A S, Jensen M E, Schweickert P A. Value of bone scan imaging in predicting pain relief from percutaneous vertebroplasty in osteoporotic vertebral fractures.  AJNR Am J Neuroradiol . 2000;  21 1807-1812
• 14 Mathis J M, Petri M, Naff N. Percutaneous vertebroplasty treatment of steroid-induced osteoporotic compression fractures.  Arthritis Rheum . 1998;  41 171-175
• 15 Deramond H, Depriester C, Toussaint P, Galibert P. Percutaneous vertebroplasty.  Semin Muskuloskelet Radiol . 1997;  1 285-295
• 16 Deramond H, Depriester C L, Galibert P, Le Gars D. Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications and results.  Radiol Clin North Am . 1998;  36 533-546
• 17 Chiras J, Depriester C, Weill A, Sola-Martinez M Y, Deramond H. Percutaneous vertebroplasty: technique and indications.  J Neuroradiol . 1997;  24 45-59
• 18 Mathis J M. Procedural techniques and materials: tumors and osteoporotic fractures. In: Mathis JM, Deramond H, Belkoff SM, eds. Percutaneous Vertebroplasty New York: Springer-Verlag 2002: 81-107
• 19 Vasconcelos C, Gailloud P, Beauchamp N J, Heck D V, Murphy K J. Is percutaneous vertebroplasty without pretreatment venography safe?.  <~>Evaluation of 205 consecutives procedures. AJNR Am J Neuroradiol . 2002;  23 913-917
• 20 Kim A K, Jensen M E, Dion J E. Unilateral transpedicular percutaneous vertebroplasty: initial experience.  Radiology . 2002;  222 737-741
• 21 Orlando Ortiz  A, Deramond H.. Spine anatomy. In: Mathis JM, Deramond H, Belkoff SM, eds. Percutaneous Vertebroplasty. New York: Springer-Verlag 2002: 7-23
• 22 Cortet B, Cotten A, Boutry N. Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study.  J Rheumatol . 1999;  26 2222-2228
• 23 Grados F, Depriester C, Cayrolle G. Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty.  Rheumatology . 2000;  39 1410-1414
• 24 Heini P F, Walchli B, Berlemann U. Percutaneous vertebroplasty with PMMA: operative technique and early results. A prospective study for the treatment of osteoporotic compression fractures.  Eur Spine J . 2000;  9 445-450
• 25 Dudeney S, Lieberman I. Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study.  J Rheumatol . 2000;  27 2526
• 26 Zoarski G H, Snow P, Olan W J. Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long term outcomes.  J Vasc Interv Radiol . 2002;  13 139-48
• 27 Deramond H, Dion J E, Chiras J. Complications. In: Mathis JM, Deramond H, Belkoff SM, eds. Percutaneous Vertebroplasty New York: Springer-Verlag 2002: 165-173
• 28 Cyteval C, Sarrabere M P, Roux J O. Acute osteoporotic vertebral collapse: open study on percutaneous injection of acrylic surgical cement in 20 patients.  AJR Am J Roentgenol . 1999;  173 1685-1690
• 29 Padovani B, Kasriel O, Brunner P, Peretti-Viton P. Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty.  AJNR Am J Neuroradiol . 1999;  20 375-377