[Vertebroplasty: state of the art].
Over the last 10 years, there has been much development in the management of metastatic and osteoporotic vertebral compression fractures using vertebroplasty. This percutaneous image-guided interventional radiology procedure allows stabilization of a vertebral body by injection of an acrylic cement and frequently results in significant symptomatic relief. During cement polymerisation, an exothermic reaction may destroy adjacent tumor cells. Advances have been made to reduce complications from extravasation of cement in veins or surrounding soft tissues. Safety relates to experience but also to technical parameters: optimal cement radio-density, adequate digital fluoroscopy unit (single or bi-plane digital angiography unit), development of cements other than PMMA to avoid the risk of adjacent vertebral compression fractures. The rate of symptomatic relief from vertebroplasty performed for its principal indications (vertebral hemangioma, metastases, osteoporotic fractures) reaches 90-95%. The rate of complications is about 2% for metastases and less than 0.5% for osteoporotic fractures. Vertebroplasty plays a major role in the management of specific bone weakening vertebral lesions causing, obviating the need for kyphoplasty.
Chiras
J
J
Service de Neuro-radiologie diagnostique et interventionnelle, bâtiment Babinski, Groupe hospitalier Pitié-Salpetrière, 47-83 boulevard de l'Hôpital, 75651 Paris Cedex 13, France. jacques.chiras@psl.aphp.fr
Barragán-Campos
H M
HM
Cormier
E
E
Jean
B
B
Rose
M
M
LeJean
L
L
D000792:Angiography; D001843:Bone Cements / Q000627:therapeutic use; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000517:prevention & control; D005471:Fluoroscopy; D050815:Fractures, Compression / Q000601:surgery; D006391:Hemangioma / Q000150:complications; D006801:Humans; D009101:Multiple Myeloma / Q000556:secondary; D010024:Osteoporosis / Q000150:complications; D015641:Radiography, Interventional; D015642:Radiology, Interventional; D012449:Safety; D016103:Spinal Fractures / Q000601:surgery; D013125:Spinal Neoplasms / Q000150:complications / Q000556:secondary; D054854:Vertebroplasty / Q000009:adverse effects / Q000379:methods / Q000639:trends
D001843:Bone Cements