Procedure Frequently Asked Questions

• What are the indications for vertebroplasty?
• What are the diagnostic requirements for evaluating indications?
• What equipment do I need to perform this procedure?
• Can I perform this procedure in the OR?
• What cement is used?
• What are the long-term effects of bone cement in the spine?
• What published clinical outcome studies would you recommend?
• Where would you recommend receiving training to perform this procedure?

What are the indications for vertebroplasty?

Percutaneous Vertebroplasty is indicated primarily for the reduction of pain related to vertebral compression fractures. Mose of the treated patients suffered from pathological fractures related to osteoporosis. However, Vertebroplasty is also useful for reducing pain related benign lesion (hemangionma), and malignant lesions (metastaic cancers, myeloma). Review detailed information about indications and contraindications.

What are the diagnostic requirements for evaluating indications?

Because of the frequency of multiple fractures in this population of patients, careful clinical and imaging correlation is required to determine the etiology and level of the patient's pain. Findings on plain radiographs and MRI, particularly MR demonstration of edema within a fractured vertebral body, should correlate with the level of tenderness upon palpation of the spinous processes. MRI stir sequences are most useful for the depiction of edema. A bone scan showing activity in the fracture is helpful for confirming the more recent fracture in a patient with multiple fractures over an extended period.

What equipment do I need to perform this procedure?

Vertebroplasty should be performed under high quality imaging equipment such as an angio suite; digital imaging is superior to analog. Bi-plane imaging facilitates the procedure, but is not required. Portable C-arm units are acceptable; please note that some earlier versions of portable C-arms do not provide adequate imaging for safe injection of opacified cement. You should always check visibility of cement using your equipment prior to scheduling an initial procedure.

Can I perform this procedure in the OR?

Percutaneous vertebroplasty can be performed in the operating room using a high quality portable C-arm as described above. General anesthesia is not necessary, and therefore the operating room forum or surgical center are both appropriate.

What cement is used?

Various polymethylmethacrylate cements have been used; however most physicians utilize a cement indicated for craniofacial defect repair mixed with commercially available Barium Sulfate to approximately a 30% barium mixture by weight. Adequate opacification must be achieved in order to perform the procedure safely.

What are the long-term effects of bone cement in the spine?

Polymethylmethacrylate has been used for over four decades as an orthopedic cement and the side effects have been studied. The strength of the bone cement and durability would be expected to outlast the native bone in elderly, osteoporotic patients. The long-term effects of bone cement in percutaneous vertebroplasty have been covered in numerous peer-reviewed journal articles. Refer to the Research Articles for more information.

What published clinical outcome studies would you recommend?

Hundreds of scientific papers have been published on vertebroplasty and can be located via Medline. The results of these studies suggest a remarkable benefit over conservative therapy. Long-term studies also need to be performed to rule out the possibility of any long-term sequelae. Refer to the Research Articles for links to recent peer reviewed articles and other resources.

Where would you recommend receiving training to perform this procedure?

Training programs are available at various times and locations across the U.S.

For more information, call
1-877-620-BACK or use our online request form.