Percutaneous vertebroplasty for benign and malignant vertebral diseases

Objective To study the key technique and therapeutic effect of percutaneous vertebroplasty (PVP). Methods Forty-four patients with 57 vertebrae underwent PVP, including 13 osteoporotic vertebral compression fractures (VCFs) in 12 cases and 44 vertebral tumors in 32 cases. Intraosseous venography was performed followed by injecting bone cement under the fluoroscopy. The score of visual analogue scale point (VAS) (10-point scale) before vertebroplasty, 24 hours, one week and one month after vertebroplasty was recorded respectively. Result of pain relief and complications were observed. Results The procedure was technically successful in all patients. The amount of bone cement injected in each vertebra of patients with VCFs was in average (5.2±1.3) ml, while in patients with vertebral tumors was (5.1±1.2) ml. There was no significant difference between the two groups (P0.05). The overall rate of pain relief was 93.2% after 30 days of the operation. There are significant differences among the score of VAS with different time points (P0.05). The score of VAS after vertebroplasty in patients with VCFs was lower than patients with tumors (P0.05). No further or new vertebral compression occurred in all patients during the follow-up of 1-12 months. No major complications occurred in this series, except asymptoamic bone cement leaking around vertebrae. Conclusion PVP could provide significant pain reduction and vertebral strengthening in the treatment of patient with different vertebral disease. The effect of pain relief was not related to the amount of bone cement injected. Patients with osteoporotic VCFs have better therapeutic effect than patients with vertebral tumors. Adopting proper puncture technique, using pretreatment intraosseous venography and injecting bone cement reasonably under fluoroscopy were the key techniques to improve success rate of operation and prevent complications of PVP.