Computed tomography (CT) and flouroscopy-guided vertebroplasty: Results and complications in 187 patients

Over the past 9 years, percutaneous injection of methyl methacrylate into p athologic vertebral bodies (vertebroplasty) was performed in 187 patients. A total of 289 ver tebroplasties (mean: 1.54 vertebra/patient) were perform ed. The procedure was guided under computed tomography (CT) and fluoroscopy . The indications for vertebroplasty were severe painful osteoporosis in 10 5 cases, vertebral body tumors in 69 cases, symptomatic vertebral hemangiom a in 11 cases, and postsurgical consolidation in two cases. Satisfactory re sults based on the reduction of analgesics were obtained in osteoporosis in 78% of the cases, in tumoral lesions in 83% of the cases, and in hemangiom a in 73% of the cases. In 14 cases an epidural leak was observed that cause d neuralgia in three cases, only without spinal cord compression. In one ca se, paravertebral overflow was observed along the needle tract; the glue wa s extracted percutaneously 2 days later. In two cases, the control CT scan reported an asymptomatic pulmonary embolus. The most critical elements to s uccessful vertebroplasty are proper patient selection, correct needle place ment, good timing with injection of pasty glue, and operator experience.