ABSTRACT
This chapter discusses the conventional percutaneous vertebroplasty using polymethylmethacrylate (PMMA) for the management of painful thoracolumbar osteoporotic vertebral compression fractures (VCFs). Vertebroplasty ordinarily refers to the percutaneous, intravertebral injection of PMMA for vertebral stabilization and relief of pain. Plain radiography is usually the initial diagnostic imaging modality and bears important information for surgical planning and technique. Osteoporotic fracture classification schemes may be unfamiliar to some spine surgeons. Nuclear scintigraphic bone scanning is a sensitive, readily accessible, inexpensive means of detecting the locations and extent of fracture provided at least 48 to 72 hours have elapsed since the fracture event. Magnetic resonance imaging (MRI) is the single most useful imaging modality in the evaluation of osteoporotic VCF. MRI will identify intravertebral edema within hours of fracture, identify all involved fracture levels, define intravertebral clefts, and assist in the exclusion of pathologic fracture.
