PERCUTANEOUS VERTEBROPLASTY - STATE-OF-THE-ART

Vertebroplasty is an effective new radiologic procedure consisting of the percutaneous injection of a biomaterial, usually methyl methacryla te, into a lesion of a vertebral body, This technique allows marked or complete pain relief and bone strengthening in most cases, The princi pal indications for vertebroplasty are osteolytic metastasis and myelo ma, painful or aggressive hemangioma, and osteoporotic vertebral colla pse with debilitating pain that persists despite correct medical treat ment, Radiography and computed tomography must be performed in the day s preceding vertebroplasty to assess the extent of vertebral collapse, the location and extent of the lytic process, the visibility and degr ee of involvement of the pedicles, the presence of cortical destructio n or fracture, and the presence of epidural or foraminal stenosis caus ed by tumor extension or bone fragment retropulsion. Leakage of methyl methacrylate during vertebroplasty may cause compression of adjacent structures and necessitate emergency decompressive surgery; thus, the procedure should be performed only in a surgical center. The decision to perform vertebroplasty should be made by a multidisciplinary team b ecause the choice between vertebroplasty, surgery, radiation therapy, medical treatment, or a combination thereof depends on a number of fac tors, Radiologists need to be aware of the various indications for ver tebroplasty and of potential future developments and applications of t he procedure.