The strengthening effect of percutaneous vertebroplasty

To examine whether single-needle vertebroplasty is effective in strengthening vertebrae.

Four adjacent intact lumbar vertebrae were removed from each of nine adult post-mortem subjects. One or two vertebra of each set was injected with low viscosity acrylic bone cement using a single-track posterolateral approach. Vertebral strength was measured during constant rate axial compression.

Single-needle injection delivered different quantities of cement (1-8 ml) in an asymmetric distribution. Injected vertebrae were stronger than controls in 10 out of 12 cases (P < 0.01), suggesting that cement injection increases the load needed to cause initial vertebral fracture. Compression was continued past the point of initial failure, to simulate progressive vertebral collapse. Injected specimens were more resistant to deformation than control specimens (P < 0.05), most of which initially deformed with little increase in load.

Single-track injection of bone cement appeared to strengthen vertebrae against both initial failure and subsequent collapse. The magnitude of strength increase from vertebroplasty was variable, and did not correlate with the volume of cement injected. Further investigation is needed to optimize the technique.Gishen, P. (2000). Clinical Radiology55, 471-476.