Vertebroplasty

Vertebral compression fracture is a significant problem associated with pain and functional impairment. Traditional open surgery has been problematic in the management of patients in this population because of poor bone quality, frequent and extensive medical comorbidity. Nonoperative management, including medications for pain relief and bracing, has been used traditionally; however, many patients are left with incapacitating residual pain and are unable to return to their previous level of activity. Limitations in the management of vertebral compression fractures have provided impetus for the development and refinement of percutaneous treatment methods suh as vertebroplasty and kyphoplasty. Vertebroplasty is a percutaneous procedure in which polymethyl methacrylate (PMMA) is injected into the fractured vertebral body. Percutaneous vertebral body augmentation with vertebroplasty has now gained widespread acceptance for the treatment of osteoporotic vertebral body fractures, as well as a number of other pathologic conditions. Principally used for their effectiveness in pain relief and subsequent acceleration of patients functional status, they have proved to be significant advancements in the treatment of patients with osteoporotic compression fractures. The most common complications associated with these procedures are pain and tenderness at the site of needle insertion, extravasation of cement and its secondary effects. Nevertheless, in the hands of experienced operators, these risks are thought to be minimized to an acceptable rate. [Archives Medical Review Journal 2012; 21(4.000): 283-298]