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

Over the past 9 years, percutaneous injection of methyl methacrylate into pathologic vertebral bodies (vertebroplasty) was performed in 187 patients. A total of 289 ver tebroplasties (mean: 1.54 vertebra/patient) were performed. The procedure was guided under computed tomography (CT) and fluoroscopy. The indications for vertebroplasty were severe painful osteoporosis in 105 cases, vertebral body tumors in 69 cases, symptomatic vertebral hemangioma in 11 cases, and postsurgical consolidation in two cases. Satisfactory results 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 hemangioma in 73% of the cases. In 14 cases an epidural leak was observed that caused neuralgia in three cases, only without spinal cord compression. In one case, paravertebral overflow was observed along the needle tract; the glue was extracted percutaneously 2 days later. In two cases, the control CT scan reported an asymptomatic pulmonary embolus. The most critical elements to successful vertebroplasty are proper patient selection, correct needle placement, good timing with injection of pasty glue, and operator experience.