الفهرس 
ANATOMY
Clinical EvaluationOnly 14 pages are availabe for public view
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Abstract
Severe back pain after vertebral compression fractures is a common medical problem. Vertebral compression fractures occur in weakened vertebrae due to either trabecular loss of the bone in osteoporosis, or due to vertebral destruction in benign or malignant tumors such as hemangioma, osteolytic metestasis or multiple myeloma. Patients who tend to respond best to PV are those with only a single-level or a few well-defined levels of focal pain and tenderness corresponding to the site of VCF by plain radiographs or magnetic resonance imaging. Absolute contraindications include spinal cord compression at the level of VCF, uncorrectable coagulopathy, allergy to bone cement or opacification agent, ongoing local or systematic infection and therapy of more than 3 vertebrae in one session. Transpedicular approach is the classic root for introduction of the needle into the vertebral body. The parapedicular approach is used when the pedicle is small size or destroyed. The antrolateral approach is used in the cervical region. Vertebral biopsy is performed coaxially throw the vertebroplasty needle when the etiology of VCF is in question. Vertebral venograghy is performed to ensure that needle tip is not in a major draining vein, and to predect the site of cement leakage. Cement is injected under real time fluoroscopic monitoring. Injection is stoped when cement reach posterior one third of the vertebral body or when leakage occurs. CT is used alone or in combination with fluoroscopy to perform vertebroplasty especially in neoplastic cases, thoracic and cervical region. (4) Reports on the outcomes of vertebroplasty have suggested that a majority of patients experience partial or complete pain relief within seventy-two hours after the procedure and improved functional levels and mobility and reduced need for analgesic medications. Most complications can result from extravertebral leakage of considerable amount of cement causing spinal cord or nerve root compression or pulmonary embolism. When PV is performed to treat osteoporotic VCFs, the incidence of symptomatic complications is less than 1%, whereas complication rates range from 5% to 10% when PV is performed to treat vertebral bodies that are infiltrated with malignant neoplasms. It has been suggested that there is an increased incidence of new fractures in adjacent vertebrae following vertebroplasty due to preexistent bone fragility in an osteoporotic patient, immediate increase in stiffness and strength in the treated vertebral body, and improved mobility that causes a new load on vertebral bodies. • Percutaneous vertebroplasty (PV) is a safe and efficient therapeutic option for patients suffering from otherwise untreatable painful VCFs and disability caused by osteoporosis or sever osteolysis secondary to tumoral involvement of a vertebra. • Percutaneous vertebroplasty is a minimally invasive, radiologically-guided interventional procedure. It involves percutaneous injection of vertebral body with an acrylic polymer to provide strengthening and stabilization of the fracture. • Complications of percutaneous verteboplasty are rare and mostly result from cement leakage outside the vertebral body.