Percutaneous vertebroplasty in the treatment of diseases causing vertebral bone loss

Background. Percutaneous vertebroplasty involves the injection of acrylic surgical cement into the vertebral body. The basic principles of vertebroplasty and the authors' own clinical experiences are described. Material and methods. Between November 1999 and January 2005 the authors performed percutaneous vertebroplasty on 75 patients: 45 with osteoporotic compression fractures, 15 with angiomas of the vertebral bodies, and 12 patients with spinal neoplasms. There were also 3 patients with coexisting spinal angiomas and osteoporotic compression fractures. All these patients were treated under local anesthesia. Cement injections were realized by the transpedicular approach under fluoroscopic guidance; in certain cases a CT-guided approach was used. The clinical outcome was assessed based on follow-up examinations, the Oswestry questionnaire, and the Visual Analog Pain Scale. Plain x-rays or CT scans were made for purposes of radiological evaluation. Results. Follow-up examinations revealed pain relief or significant reduction of pain in 89% of the patients. In 2 cases (3%) vertebroplasty was complicated by intracanal leakage of cement. Conclusions. Percutaneous vertebroplasty is well tolerated by patients. Filling with cement is effective in the treatment of osteoporotic compression fractures and of vertebral angiomas.