Vertebroplasty as a treatment for painful pathological fractures of the vertebral column

Vertebral fracture due to a metabolic bone disease or a neoplastic disease is a common and debilitating condition occurring mostly due to osteoporosis or metastatic bone disease. Some of the patients suffering from such fractures continue to complain of back pain and deformity despite optimal medical therapy. Vertebroplasty, i.e. transcutaneous injection of bone cement into the vertebral body can serve as an internal fixation device and allows restoration of mechanical strength and partial restoration of the vertebral height. During the year 2000, 17 vertebrae in 12 patients were injected. These were either lumbar or thoracic vertebrae. All patients reported a decrease in pain and improved ambulation capacity. Two minor complications were encountered including headache lasting for 72 hours prior to spontaneously resolving. This possibly indicates a trans-arachnoidal approach. The other complication encountered was cement leak below the posterior longitudinal ligament. The patient reported pain amelioration. No emergency surgical interventions were necessary to date.