Postoperative Cement Augmentation After 360-Degree Fixation for Highly Unstable Vertebral Fractures in Patients with Multiple Myeloma: A Technical Note on Delayed Trans-Instrumentation Vertebroplasty

In spite of the associated challenges of such an interventional procedure due to the presence of extensive hardware, carrying out delayed trans-instrumentation vertebroplasty after 360-degree circumferential fixations is not only feasible, but in our opinion, may constitute the best strategy to optimize the strength of spinal instrumentation in challenging scenarios involving poor bone quality, such as in patients with multiple myeloma.