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Practical Guidelines for Percutaneous Vertebral Cementoplasty

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Interventional Neuroradiology of the Spine

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Abstract

Minimally invasive percutaneous vertebral cementoplasty (PVC) is an interventional neuroradiological procedure. It comprises percutaneous injection of bone cement (usually polymethyl methacrylate (PMMA)) [1–8] in a weakened vertebral body under imaging guidance (computed tomography (CT) or digital subtraction angiography (DSA)). PVC provides mechanical reinforcement and stabilization with or without plastic restoration of the height of the vertebral body, thereby reducing or eliminating pain. There is appreciable scientific consensus (supported by a consensus document published in 2007 [9] that PVC is a successful, safe and effective minimally invasive procedure in selected patients with painful vertebral compressive fractures (VCFs) or microfractures [5–29]. Several case series and retrospective studies have shown statistically significant pain relief and improvement of mobility and function with a consistently high success rate.

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References

  1. Galibert P, Deramond H, Rosat P et al (1987) Note préliminaire sur le traitement des angiomes vertäbraux par vertebroplastie percutanäe. Neurochirurgie 33:166–168

    PubMed  CAS  Google Scholar 

  2. Deramond H, Darrason R, Galibert P (1989) Percutaneous vertebroplasty with acrylic cement in the treatment of aggressive spinal angiomas. Rachis 1:143–153

    Google Scholar 

  3. Debussche-Depriester C, Deramond H, Fardellone P et al (1991) Percutaneous vertebroplasty with acrylic cement in the treatment of osteoporotic vertebral crush fracture syndrome. Neuroradiology 33(Suppl):149–152

    Google Scholar 

  4. Jensen ME, Evans AE, Mathis JM et al (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. Am J Neuroradiol 18:1897–1904

    PubMed  CAS  Google Scholar 

  5. Deramond H, Depriester C, Galibert P et al (1989) Percutaneous vertebroplasty with polymethylmethacrylate: technique, indications and results. Radiol Clin North Am 36:533–546

    Article  Google Scholar 

  6. Cotten A Boutry N Cortet B et al (1998) Percutaneous vertebroplasty: state of the art. Radiographics 18:311–32

    PubMed  CAS  Google Scholar 

  7. Barr JD, Mathis JM, Barr MS et al (2001) Standard for the performance of percutaneous vertebroplasty. American College of Radiology Standards 2000’2001. American College of Radiology, Reston, pp 441–448

    Google Scholar 

  8. McGraw JK, Cardella JC, Barr JD et al (2003) Quality improvement guidelines for percutaneous vertebroplasty. J Vasc Interv Radiol 14:827–831

    Article  PubMed  Google Scholar 

  9. Jensen ME, McGraw JK, Cardella JF, Hirsch JA (2007) Position statement on percutaneous vertebral augmentation: a consensus statement developed by the American Society of Interventional and Therapeutic Neuroradiology, Society of Interventional Radiology, American Association of Neurological Surgeons/Congress of Neurological Surgeons, and American Society of Spine Radiology. Am J Neuroradiol 28:1439–1443

    PubMed  CAS  Google Scholar 

  10. American College of Radiology (2009) Practice guideline for the performance of percutaneous vertebroplasty. ACR Practice Guidelines revised 2009 (resolution 25). American College of Radiology, Reston

    Google Scholar 

  11. Radvany MG, Murphy KJ, Millward SF et al (2009) Research reporting standards for percutaneous vertebral augmentation. J Vasc Interv Radiol 20:1279–1286

    Article  PubMed  Google Scholar 

  12. Kaemmerlen P, Thiesse P, Bouvard H et al (1989) Vertébroplastie percutanée dans le traitement des métastases: technique et résultats. J Radiol 70:557–562

    PubMed  CAS  Google Scholar 

  13. Nguyen JP, Djindjian M, Pavlovitch JM et al (1989) Vertebral hemangioma with neurologic signs: therapeutic results-survey of the French Society of Neurosurgery. Neurochirurgie 35:299–303 and 305–308

    PubMed  CAS  Google Scholar 

  14. Gangi A, Kastler BA, Dietemann JL (1994) Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. Am J Neuroradiol 15:83–86

    PubMed  CAS  Google Scholar 

  15. Cotten A, Dewatre F, Cortet B et al (1996) Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical followup. Radiology 200:525–530

    PubMed  CAS  Google Scholar 

  16. Weill A, Chiras J, Simon J et al (1996) Spinal metastases: indications for and results of percutaneous injection of acrylic cement. Radiology 199:241–247

    PubMed  CAS  Google Scholar 

  17. Barr JD, Barr MS, Lemley TJ et al (2000) Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 25:923–928

    Article  PubMed  CAS  Google Scholar 

  18. Martin JB, Jean B, Sugiu K et al (1999) Vertebroplasty: clinical experience and follow-up results. Bone 25:11S-15S

    Google Scholar 

  19. Kaufmann TJ, Jensen ME, Schweickert PA et al (2001) Age of fracture and clinical outcomes of percutaneous vertebroplasty. Am J Neuroradiol 22:1860–1863

    PubMed  CAS  Google Scholar 

  20. Evans AJ, Jensen ME, Kip KE et al (2003) Vertebral compression fractures: pain reduction and improvement in functional mobility after percutaneous polymethylmethacrylate vertebroplasty-retrospective report of 245 cases. Radiology 226:366–372

    Article  PubMed  Google Scholar 

  21. Muto M, Muto E, Izzo R, Diano AA, Lavanga A, Di Furia U (2005) Vertebroplasty in the treatment of back pain. Radiol Med109:208–219

    Google Scholar 

  22. Heini PF, Walchli B, Berlemann U (2000) Percutaneous transpedicular vertebroplasty with PMMA: operative technique and early results-a prospective study for the treatment of osteoporotic compression fractures. Eur Spine J 9:445–450

    Article  PubMed  CAS  Google Scholar 

  23. McGraw JK, Lippert JA, Minkus KD et al (2002) Prospective evaluation of pain relief in 100 patients undergoing percutaneous vertebroplasty: results and follow-up. J Vasc Interv Radiol 13:883–886

    Article  PubMed  Google Scholar 

  24. Zoarski GH, Snow P, Olan WJ et al (2002) Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of longterm outcomes. J Vasc Interv Radiol 13:139–148

    Article  PubMed  Google Scholar 

  25. Diamond TH, Champion B, Clark WA (2003) Management of acute osteoporotic vertebral fractures: a non-randomized trial comparing percutaneous vertebroplasty with conservative therapy. Am J Med 114:257–265

    Article  PubMed  Google Scholar 

  26. Do HM, Marcellus ML, Weir RU et al (2002) Percutaneous vertebroplasty versus medical therapy for treatment of acute vertebral body compression fractures: a prospective randomized study. Proceedings of the Annual Meeting of the American Society of Neuroradiology, Vancouver

    Google Scholar 

  27. Kallmes DF, Comstock BA, Heagerty PJ et al (2009) A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 361:569–579

    Article  PubMed  CAS  Google Scholar 

  28. Buchbinder R, Osborne RH, Ebeling PR et al (2009) A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 361:557–568

    Article  PubMed  CAS  Google Scholar 

  29. Rousing R, Andersen MO, Jespersen SM (2009) Percutaneous vertebroplasty compared to conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures: three-months followup in a clinical randomized study. Spine 34:1349–1354

    Article  PubMed  Google Scholar 

  30. Voormolen MH, Mali WP, Lohle PN (2007) 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. Am J Neuroradiol 28:555–560

    CAS  Google Scholar 

  31. Venmans A, Klazen CA, Lohle PN, Mali WP, van Rooij WJ (2012) Natural history of pain in patients with conservatively treated osteoporotic vertebral compression fractures: Results from VERTOS II. Am J Neuroradiol 33:519–521

    Article  PubMed  CAS  Google Scholar 

  32. Wardlaw D, Cummings SR, Van Meirhaeghe J et al (2009) Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet 373:1016–1024

    Article  PubMed  Google Scholar 

  33. Feltes C, Fountas KN, Machinis T et al (2005) Immediate and early postoperative pain relief after kyphoplasty without significant restoration of vertebral body height in acute osteoporotic vertebral fractures. Neurosurg Focus 18:e5

    Article  PubMed  Google Scholar 

  34. Kasperk C, Hillmeier J, Noldge G et al (2005) Treatment of painful vertebral fractures by kyphoplasty in patients with primary osteoporosis: a prospective nonrandomized controlled study. J Bone Miner Res 20:604–612

    Article  PubMed  Google Scholar 

  35. Gaitanis IN, Hadjipavlou AG, Katonis PG et al (2005) Balloon kyphoplasty for the treatment of pathological vertebral compressive fractures. Eur Spine J 14:250–260

    Article  PubMed  Google Scholar 

  36. Berlemann U, Franz T, Orler R et al (2004) Kyphoplasty for treatment of osteoporotic vertebral fractures: a prospective non-randomized study. Eur Spine J 13:496–501

    Article  PubMed  Google Scholar 

  37. Fribourg D, Tang C, Sra P et al (2004) Incidence of subsequent vertebral fracture after kyphoplasty. Spine 29:2270–2276 (discussion 2277)

    Article  PubMed  Google Scholar 

  38. Majd ME, Farley S, Holt RT (2005) Preliminary outcomes and efficacy of the first 360 consecutive kyphoplasties for the treatment of painful osteoporotic vertebral compression fractures. Spine J 5:244–255

    Article  PubMed  Google Scholar 

  39. Fairbank JC, Pynsent PB (2000) The Oswestry Disability Index. Spine 15:25:2940–2952 (discussion 2952)

    Article  Google Scholar 

  40. Bombardier C. (2000) Outcome assessments in the evaluation of treatment of spinal disorders: summary and general recommendations. Spine 25:3100–3103

    Article  PubMed  CAS  Google Scholar 

  41. Mousavi SJ, Parnianpour M, Mehdian H, Montazeri A, Mobini B (2006) The Oswestry Disability Index, the Roland-Morris Disability Questionnaire, and the Quebec Back Pain Disability Scale: translation and validation studies of the Iranian versions. Spine 31:E454–E459

    Article  PubMed  Google Scholar 

  42. Calmels P, Béthoux F, Condemine A, Fayolle-Minon I (2005) Low back pain disability assessment tools. Ann Readapt Med Phys 48:288–297

    Article  PubMed  CAS  Google Scholar 

  43. DeLoach LJ, Higgins MS, Caplan AB, Stiff JL (1998) The visual analog scale in the immediate postoperative period: intrasubject variability and correlation with a numeric scale. Anesth Analg 86:102–106

    PubMed  CAS  Google Scholar 

  44. Bodian CA, Freedman G, Hossain S, Eisenkraft JB, Beilin Y (2001) The visual analog scale for pain: clinical significance in postoperative patients. Anesthesiology 95:1356–1361

    Article  PubMed  CAS  Google Scholar 

  45. Calmels V, Vallée JN Rose M, Chiras J (2007) Osteoblastic and mixed spinal metastases: evaluation of the analgesic efficacy of percutaneous vertebroplasty. Am J Neuroradiol 28:570–574

    PubMed  CAS  Google Scholar 

  46. Shiely JC, Bayliss MS, Keller SD et al (1996) SF-36 health survey annotated bibliography: first edition (1988–1995). New England Medical Center, Boston

    Google Scholar 

  47. Nussbaum DA, Gailloud P, Murphy K (2004) A review of complications associated with vertebroplasty and kyphoplasty as reported to the food and drug administration medical device related website. J Vasc Interv Radiol 15:1185–1192

    Article  PubMed  Google Scholar 

  48. Choe DH, Marom EM, Ahrar K et al (2004) Pulmonary embolism of polymethyl methacrylate during percutaneous vertebroplasty and kyphoplasty. Am J Roentgenol 183:1097–1102

    Article  Google Scholar 

  49. Lim TH, Breback GT, Renner SM et al (2002) Biomechanical evaluation of an injectable calcium phosphate cement for vertebroplasty. Spine 27:1297–1302

    Article  PubMed  Google Scholar 

  50. Lieberman IH, Togawa D, Kayanja MM (2005) Vertebroplasty and kyphoplasty: filler materials. Spine J 5 (Suppl):S305–S316

    Article  Google Scholar 

  51. Siris ES, Brenneman SK, Barrett-Connor E et al (2006) The effect of age and bone mineral density on the absolute, excess, and relative risk of fracture in postmenopausal women aged 50–99: results from the National Osteoporosis Risk Assessment (NORA). Osteoporos Int 17:565–574

    Article  PubMed  CAS  Google Scholar 

  52. Anselmetti GC, Bonaldi G, Carpeggiani P, Manfré L, Masala S, Muto M (2010) Vertebral augmentation: 7 years experience. ACTA Neurochirurgica Supplementum 108:147–161

    Article  Google Scholar 

  53. Muto M, Perrotta V, Guarnieri G et al (2008) Vertebroplasty and kyphoplasty: friends or foes? Radiol Med 113:1171–1184

    Article  PubMed  CAS  Google Scholar 

  54. Callstrom MR, Charboneau JW (2007) Image-guided palliation of painful metastases using percutaneous ablation. Tech Vasc Interv Radiol 10:120–131

    Article  PubMed  Google Scholar 

  55. Simon CJ, Dupuy DE (2006) Percutaneous minimally invasive therapies in the treatment of bone tumours: thermal ablation. Semin Musculoskelet Radiol 10:137–144

    Article  PubMed  Google Scholar 

  56. Schaefer O, Lohrmann C, Markmiller M, Uhrmeister P, Langer M (2003) Technical innovation. Combined treatment of a spinal metastasis with radiofrequency heat ablation and vertebroplasty. Am J Roentgenol 180:1075–1077

    Article  Google Scholar 

  57. Callstrom MR, Atwell TD, Charboneau JW et al (2006) Painful metastases involving bone: percutaneous image-guided cryoablation-prospective trial interim analysis. Radiology 241:572–580

    Article  PubMed  Google Scholar 

  58. Geogy BA, Wong W (2007) Plasma-mediated radiofrequency ablation assisted percutaneous cement injection for treating advanced malignant vertebral compression fractures. Am J Neuroradiol 28:700–705

    Google Scholar 

  59. Fox M, Onofrio B (1993) The natural history and management of symptomatic and asymptomatic vertebral hemangiomas. J Neurosurg 78:36–45

    Article  PubMed  CAS  Google Scholar 

  60. Acosta FL, Christopher FD (2006) Current strategies and outcomes in management of symptomatic vertebral hemangiomas. Neurosurgery 58:287–295

    Article  PubMed  Google Scholar 

  61. Guarnieri G, Ambrosanio G, Vassallo P et al (2009) Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up. Neuroradiology 51:471–476

    Article  PubMed  CAS  Google Scholar 

  62. Guarnieri G, Ambrosanio G, Pezzullo MG et al (2009) Management of vertebral re-fractures after vertebroplasty in osteoporotic patients. Interv Neuroradiol 29:153–157

    Google Scholar 

  63. Pateder DB, Khanna AJ, Lieberman IH (2007) Vertebroplasty and kyphoplasty for the management of osteoporotic vertebral compression fractures. Orthop Clin North Am 38:409–418; Abstract vii

    Article  PubMed  Google Scholar 

  64. Gregory BA (2010) Clinical experience with high viscosity cements for percutaneous vertebral body augmentation: occurrence, degree, and location of cement leakage compared with kyphoplasty. Am J Neuroradiol 31:504–508

    Article  Google Scholar 

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  1. Neuroradiology Department, A. Cardarelli Hospital, Naples, Italy

    Mario Muto

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  1. Pedro Nunnes
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  2. Vitor Mendes Pereira
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  3. Mario Muto
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  1. Neuroradiology Department, A. Cardarelli Hospital, Naples, Italy

    Mario Muto

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Nunnes, P., Pereira, V.M., Muto, M. (2013). Practical Guidelines for Percutaneous Vertebral Cementoplasty. In: Muto, M. (eds) Interventional Neuroradiology of the Spine. Springer, Milano. https://doi.org/10.1007/978-88-470-2790-9_19

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  • DOI: https://doi.org/10.1007/978-88-470-2790-9_19

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