[Vertebroplasty and balloon kyphoplasty]

Since the first report more than 20 years ago, vertebroplasty is now performed as a routine procedure by radiologists. The main goal of this technique is to fill the fractured vertebral body with PMMA cement to improve its stability. The efficiency of vertebroplasty on spinal pain related to osteoporotic fractures or the tumorous process has been widely described in the literature. However, the main problem of this percutaneous approach is the risk of cement leakage; to avoid this danger, balloon kyphoplasty was developed. There are two main goals of using balloons: first to reduce the deformity of the fractured vertebral body by inflation and then to fill the cavity created with cement injected without pressure. During the last 8 years kyphoplasty has been used and has shown its efficacy on spinal pain related to osteoporotic fractures, tumorous processes, and myeloma. Reducing the risk of cement leakage was also an opportunity to increase percutaneous technique indications in the treatment of various spinal diseases. These two techniques require appropriate training and are associated with a long learning curve. They must be used in optimal technical conditions, with strict asepsis and a good radioscopic device. The possibilities of treating various spinal pathologies (osteoporosis, tumors, and myeloma) with vertebroplasty or kyphoplasty are interesting, but a multidisciplinary approach with the skills of an oncologist, a radiologist, spine surgeons, and a rheumatologist is most advantageous.