Extending polymerization time of polymethylmethacrylate cement in percutaneous vertebroplasty with ice bath cooling

Currently available preparations of polymethylmethacrylate (PMMA) cement for percutaneous vertebroplasty have injectability times of 4-15 minutes. The potential for early polymerization requires procedures to be performed as fast as possible, sometimes with suboptimal results and waste of the cement. By cooling the PMMA mixture in an iced bath of sodium chloride solution, we can extend its injectability to over 2 hours and use one kit for the controlled treatment of multiple levels with successive needle placements. We have been using this technique since mid-1998, treating more than 600 vertebral bodies.