The current status of percutaneous vertebroplasty in Canada

To provide an overview of the current status of percutaneous vertebroplasty (PVP) practice in Canada, including the preprocedure work up, operative technique and follow-up practice of physicians performing the procedure in this country.

Questionnaires were emailed to 31 institutions performing percutaneous vertebroplasty across Canada.

Twenty-three (74.2%) completed surveys were returned, representing data from 1516 vertebroplasties performed by 66 radiologists and surgeons. Preoperative routine imaging and screening practice varies widely. The majority of respondents perform PVP under conscious sedation; however, an anaesthetist is present in only 22% of institutions. Biplane fluoroscopy is used in 43.5% of practices. The preference for unipedicular or bipedicular injection varies: in 7 institutions, a unipedicular approach is used in at least 80% of cases. Patients receive a follow-up by the screening physician in 65.2% of institutions. There were 4 complications requiring treatment. Venous and intradiscal extravasation rates were 20.8% and 25.3%, respectively; however, the vast majority of these were clinically insignificant.

PVP complication rates reported in our Canadian survey compare favourably with those in the published literature. The number of PVPs performed annually in the institutions surveyed appears small, relative to the figures from the United States. The prevalence of osteoporosis and incidence of vertebral compression fractures in Canada is increasing as the population ages, and demand for PVP is likely to rise significantly in the coming years.