You are here: Home / surveys / vertebroplasty / indications contraindications

indications contraindications

Indications:

  • Symptomatic vertebral angioma.
  • Painful vertebral body tumors and acetabular tumors (particularly metastasis and myeloma). In cancer patient, percutaneous cementoplasty is used particularly in symptomatic treatment of osteolytic bone metastasis and myeloma. As PC is only aimed to treat pain and to consolidate the weight-bearing bone, other specific tumor therapy should be given in conjunction for tumor management when appropriate. The use of acrylic glue is reserved to weight-bearing bone because of the consolidation effect. In the other locations, pain can be treated with alcohol or thermoablation techniques.
  • Severe painful osteoporosis with loss of height and/or with compression fractures of the vertebral body (26, 13-19, 6-10, 36, 2, 22, 37 ). Painful compression fractures in osteoporotic patients, refractory to conservative therapy are an excellent indications of vertebroplasty. The ideal candidate for vertebroplasty presents within 4 months of the time of fracture and has midline, non-radiating back pain that increases with weight bearing and can be exacerbated by manual palpation of the spinous process of the involved vertebra. However, many have multiple fractures and lack sufficient imaging studies to document the age of some or all of their fractures. Other have several adjacent fractures that present difficulty in determining , by physical examination, which of the fractures is symptomatic. In such instances, MR imaging is extremely helpful with edema within the marrow space of the vertebral body, best visualized on sagittal T2-weighted imaging. Bone scan imaging can be used to help to differentiate the symptomatic level from incidentally discovered fractures too.

Contraindications:

  • Hemorrhagic diathesis
  • Infection
  • Lesions with epidural extension require careful injection to prevent epidural overflow and spinal cord compression by the cement or displaced epidural tissue.

The absolute contraindications are hemorrhagic diathesis and infection. Patients with more than five or diffuse metastases are not indicated for PC. Lesions with epidural extension require careful injection to prevent epidural overflow. We never used this technique for children or adolescents