Vertebroplasty, Kyphoplasty, and Sacroplasty
Vertebral augmentation, which includes vertebroplasty and kyphoplasty, is an effective therapy for those suffering from pathological vertebral body compression fractures. Several variant techniques have been described, but all essentially involve an image-guided injection of PMMA into the compressed vertebrae. Performed in a minimally invasive manner, vertebral augmentation can provide rapid pain relief with very little recovery. The burden of bony metastatic disease to the spine is significant in many forms of cancer. Risks of vertebral augmentation include nerve damage, bleeding, infection, and cement extravasation. Recent advances with kyphoplasty and cavity creation prior to PMMA injection have led to an increased safety profile when compared to standard vertebroplasty.
KeywordsVertebral augmentation Vertebroplasty Kyphoplasty Sacroplasty Bone metastasis Pathological vertebral body fracture Cancer-related pain
- 3.Berenson J, Pflugmacher R, Jarzem P, Zonder J, Schechtman K, Tillman JB, et al. 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):225–35.CrossRefGoogle Scholar
- 10.Tong D, Gillick L, Hendrickson FR. The palliation of symptomatic osseous metastases: final results of the study by the radiation therapy oncology group. Cancer. 2. Allan JM, Travis LB. Mechanisms of therapy related carcinogenesis. Nat Rev Cancer 2005;5(12):943–955. r 1982;50(5):893–899.Google Scholar
- 16.Tseng YY, Lo YL, Chen LH, Lai PL, Yang ST. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of pain induced by metastatic spinal tumor. Surg Neurol. 2008;70(Suppl 1):S1 78–83.Google Scholar
- 20.Fenton DS, Czervionke LF. Image-guided spine intervention. Philadelphia: Saunders; 2003.Google Scholar
- 27.Furman MB, Lee TS, Berkwitz L. Atlas of image-guided spinal procedures. Philadelphia: Saunders; 2012.Google Scholar