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Vertebroplasty in the treatment of osteoporotic vertebral body fracture

  • Musculoskeletal
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Abstract

During the last few years, vertebroplasty has gained a wide acceptance for the treatment of painful osteoporotic vertebral body fractures and osteolytic changes. However, new guidelines with significant changes in indications and technique were published recently in Europe. Therefore, the aim of this review is to highlight recent changes in indications for vertebroplasty, patient work-up and changes in procedural technique, and to give an overview of patient outcome and possible complications. Therefore, technical details like different types of fluoroscopy, needle placement, pain management during the intervention, recommended equipment, including bone cement, and the use of venography are discussed. Postprocedural issues are noted, including the risk of minor and major complications and the expected outcome of the treated patients.

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References

  1. Stallmeyer MJ, Zoarski GH, Obuchowski AM (2003) Optimizing patient selection in percutaneous vertebroplasty. J Vasc Interv Radiol 14:683–696

    PubMed  Google Scholar 

  2. Galibert P, Deramond H, Rosat P, Le Gars D (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 33:166–168

    PubMed  CAS  Google Scholar 

  3. Diamond TH, Bryant C, Browne L, Clark WA (2006) Clinical outcomes after acute osteoporotic vertebral fractures: a 2-year non-randomised trial comparing percutaneous vertebroplasty with conservative therapy. Med J Aust 184:113–117

    PubMed  Google Scholar 

  4. Hoffmann RT, Jakobs TF, Ertl-Wagner BB, Wallnofer A, Reiser MF, Helmberger TK (2003) Vertebroplasty in osteoporotic vertebral compression. Radiologe 43:729–734

    Article  PubMed  CAS  Google Scholar 

  5. Fourney DR, Schomer DF, Nader R, Chlan-Fourney J, Suki D, Ahrar K et al (2003) Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. J Neurosurg 98:21–30

    Article  PubMed  Google Scholar 

  6. Do HM (2000) Magnetic resonance imaging in the evaluation of patients for percutaneous vertebroplasty. Top Magn Reson Imaging 11:235–244

    Article  PubMed  CAS  Google Scholar 

  7. Hide IG, Gangi A (2004) Percutaneous vertebroplasty: history, technique and current perspectives. Clin Radiol 59:461–467

    Article  PubMed  CAS  Google Scholar 

  8. Peh WC, Gilula LA (2005) Percutaneous vertebroplasty: an update. Semin Ultrasound CT MR 26:52–64

    Article  PubMed  Google Scholar 

  9. Gangi A, Sabharwal T, Irani FG, Buy X, Morales JP, Adam A (2006) Quality assurance guidelines for percutaneous vertebroplasty. Cardiovasc Interv Radiol 29:173–178

    Article  Google Scholar 

  10. Mathis JM, Barr JD, Belkoff SM, Barr MS, Jensen ME, Deramond H (2001) Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. AJNR Am J Neuroradiol 22:373–381

    PubMed  CAS  Google Scholar 

  11. Mathis JM, Wong W (2003) Percutaneous vertebroplasty: technical considerations. J Vasc Interv Radiol 14:953–960

    PubMed  Google Scholar 

  12. Jensen ME, Dion JE (2000) Percutaneous vertebroplasty in the treatment of osteoporotic compression fractures. Neuroimaging Clin N Am 10:547–568

    PubMed  CAS  Google Scholar 

  13. Laredo JD, Hamze B (2004) Complications of percutaneous vertebroplasty and their prevention. Skeletal Radiol 33:493–505

    Article  PubMed  CAS  Google Scholar 

  14. Mathis JM (2003) Percutaneous vertebroplasty. Jbr-Btr 86:299–301

    PubMed  CAS  Google Scholar 

  15. Gangi A, Guth S, Imbert JP, Marin H, Dietemann JL (2003) Percutaneous vertebroplasty: indications, technique, and results. Radiographics 23:e10

    Article  PubMed  Google Scholar 

  16. White SM (2002) Anaesthesia for percutaneous vertebroplasty. Anaesthesia 57:1229–1230

    PubMed  CAS  Google Scholar 

  17. Kallmes DF, Jensen ME (2003) Percutaneous vertebroplasty. Radiology 229:27–36

    Article  PubMed  Google Scholar 

  18. Peh WC, Gilula LA (2003) Percutaneous vertebroplasty: indications, contraindications, and technique. Br J Radiol 76:69–75

    Article  PubMed  CAS  Google Scholar 

  19. Kim AK, Jensen ME, Dion JE, Schweickert PA, Kaufmann TJ, Kallmes DF (2002) Unilateral transpedicular percutaneous vertebroplasty: initial experience. Radiology 222:737–741

    Article  PubMed  Google Scholar 

  20. Tohmeh AG, Mathis JM, Fenton DC, Levine AM, Belkoff SM (1999) Biomechanical efficacy of unipedicular versus bipedicular vertebroplasty for the management of osteoporotic compression fractures. Spine 24:1772–1776

    Article  PubMed  CAS  Google Scholar 

  21. Steinmann J, Tingey CT, Cruz G, Dai Q (2005) Biomechanical comparison of unipedicular versus bipedicular kyphoplasty. Spine 30:201–205

    Article  PubMed  Google Scholar 

  22. Deramond H, Mathis JM (2002) Vertebroplasty in osteoporosis. Semin Musculoskelet Radiol 6:263–268

    Article  PubMed  Google Scholar 

  23. Vasconcelos C, Gailloud P, Beauchamp NJ, Heck DV, Murphy KJ (2002) Is percutaneous vertebroplasty without pretreatment venography safe? Evaluation of 205 consecutives procedures. AJNR Am J Neuroradiol 23:913–917

    PubMed  Google Scholar 

  24. Deramond H, Depriester C, Galibert P, Le Gars D (1998) Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. Radiol Clin North Am 36:533–546

    Article  PubMed  CAS  Google Scholar 

  25. Chavali R, Resijek R, Knight SK, Choi IS (2003) Extending polymerization time of polymethylmethacrylate cement in percutaneous vertebroplasty with ice bath cooling. AJNR Am J Neuroradiol 24:545–546

    PubMed  Google Scholar 

  26. Lieberman I, Reinhardt MK (2003) Vertebroplasty and kyphoplasty for osteolytic vertebral collapse. Clin Orthop Relat Res 2003:S176–S186

    Article  Google Scholar 

  27. Laredo JD, Hamze B (2005) Complications of percutaneous vertebroplasty and their prevention. Semin Ultrasound CT MR 26:65–80

    Article  PubMed  Google Scholar 

  28. 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 

  29. 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 web site. J Vasc Interv Radiol 15:1185–1192

    PubMed  Google Scholar 

  30. Quesada N, Mutlu GM (2006) Images in cardiovascular medicine. Pulmonary embolization of acrylic cement during vertebroplasty. Circulation 113:e295–e296

    Article  PubMed  Google Scholar 

  31. Barragan-Campos HM, Vallee JN, Lo D, Cormier E, Jean B, Rose M et al (2006) Percutaneous vertebroplasty for spinal metastases: complications. Radiology 238:354–362

    Article  PubMed  Google Scholar 

  32. Chung SE, Lee SH, Kim TH, Yoo KH, Jo BJ (2005) Renal cement embolism during percutaneous vertebroplasty. Eur Spine J 2005:1–5

    Google Scholar 

  33. Kim SY, Seo JB, Do KH, Lee JS, Song KS, Lim TH (2005) Cardiac perforation caused by acrylic cement: a rare complication of percutaneous vertebroplasty. AJR Am J Roentgenol 185:1245–1247

    Article  PubMed  Google Scholar 

  34. Padovani B, Kasriel O, Brunner P, Peretti-Viton P (1999) Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty. AJNR Am J Neuroradiol 20:375–377

    PubMed  CAS  Google Scholar 

  35. Uppin AA, Hirsch JA, Centenera LV, Pfiefer BA, Pazianos AG, Choi IS (2003) Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. Radiology 226:119–124

    Article  PubMed  Google Scholar 

  36. Kim SH, Kang HS, Choi JA, Ahn JM (2004) Risk factors of new compression fractures in adjacent vertebrae after percutaneous vertebroplasty. Acta Radiol 45:440–445

    Article  PubMed  CAS  Google Scholar 

  37. Voormolen MH, Lohle PN, Juttmann JR, van der Graaf Y, Fransen H, Lampmann LE (2006) The risk of new osteoporotic vertebral compression fractures in the year after percutaneous vertebroplasty. J Vasc Interv Radiol 17:71–76

    Article  PubMed  Google Scholar 

  38. Leeson MC, Lippitt SB (1993) Thermal aspects of the use of polymethylmethacrylate in large metaphyseal defects in bone. A clinical review and laboratory study. Clin Orthop Relat Res 1993:239–245

    Google Scholar 

  39. Deramond H, Wright NT, Belkoff SM (1999) Temperature elevation caused by bone cement polymerization during vertebroplasty. Bone 25:17S–21S

    Article  PubMed  CAS  Google Scholar 

  40. Hochmuth K, Proschek D, Schwarz W, Mack M, Kurth AA, Vogl TJ (2006) Percutaneous vertebroplasty in the therapy of osteoporotic vertebral compression fractures: a critical review. Eur Radiol 16:998–1004

    Article  PubMed  CAS  Google Scholar 

  41. Cotten A, Boutry N, Cortet B, Assaker R, Demondion X, Leblond D et al (1998) Percutaneous vertebroplasty: state of the art. Radiographics 18:311–320, discussion 20–23

    PubMed  CAS  Google Scholar 

  42. Gangi A, Dietemann JL, Mortazavi R, Pfleger D, Kauff C, Roy C (1998) CT-guided interventional procedures for pain management in the lumbosacral spine. Radiographics 18:621–633

    PubMed  CAS  Google Scholar 

  43. Singh AK, Pilgram TK, Gilula LA (2006) Osteoporotic compression fractures: outcomes after single- versus multiple-level percutaneous vertebroplasty. Radiology 238:211–220

    Article  PubMed  Google Scholar 

  44. Lieberman IH, Togawa D, Kayanja MM (2005) Vertebroplasty and kyphoplasty: filler materials. Spine J 5:305S–316S

    Article  PubMed  Google Scholar 

  45. Kaufmann TJ, Jensen ME, Schweickert PA, Marx WF, Kallmes DF (2001) Age of fracture and clinical outcomes of percutaneous vertebroplasty. AJNR Am J Neuroradiol 22:1860–1863

    PubMed  CAS  Google Scholar 

  46. Evans AJ, Jensen ME, Kip KE, DeNardo AJ, Lawler GJ, Negin GA 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 

  47. Zoarski GH, Snow P, Olan WJ, Stallmeyer MJ, Dick BW, Hebel JR et al (2002) Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. J Vasc Interv Radiol 13:139–148

    Article  PubMed  Google Scholar 

  48. O’Brien JP, Sims JT, Evans AJ (2000) Vertebroplasty in patients with severe vertebral compression fractures: a technical report. AJNR Am J Neuroradiol 21:1555–1558

    PubMed  CAS  Google Scholar 

  49. Grados F, Depriester C, Cayrolle G, Hardy N, Deramond H, Fardellone P (2000) Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheumatology (Oxford) 39:1410–1414

    Article  CAS  Google Scholar 

  50. Hodler J, Peck D, Gilula LA (2003) Midterm outcome after vertebroplasty: predictive value of technical and patient-related factors. Radiology 227:662–668

    Article  PubMed  Google Scholar 

  51. Perez-Higueras A, Alvarez L, Rossi RE, Quinones D, Al-Assir I (2002) Percutaneous vertebroplasty: long-term clinical and radiological outcome. Neuroradiology 44:950–954

    Article  PubMed  CAS  Google Scholar 

  52. Jarvik JG, Deyo RA (2000) Cementing the evidence: time for a randomized trial of vertebroplasty. AJNR Am J Neuroradiol 21:1373–1374

    PubMed  CAS  Google Scholar 

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Hoffmann, R.T., Jakobs, T.F., Trumm, C. et al. Vertebroplasty in the treatment of osteoporotic vertebral body fracture. Eur Radiol 17, 2656–2662 (2007). https://doi.org/10.1007/s00330-007-0582-5

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