Imaging for percutaneous vertebral augmentation

The objective of this review is to describe and visually depict techniques of percutaneous vertebral augmentation for treatment of painful vertebral compressive fractures. During those vertebral augmentation techniques (kypho- or vertebroplasty), bone cement, frequently polymethylmethacrylate, is injected into the vertebral body. In addition, during kyphoplasty, inflated balloons called “tamps” are placed in the vertebral body, creating the cavity before the cement injection. These procedures are most often performed in a percutaneous fashion on an outpatient basis. The mechanism of pain relief is unknown, but it is likely that stabilization of the fracture and destruction of the nociceptors lead to analgesia. Complications of such procedures are few, but some of them can be serious. Those include severe spinal canal stenosis from leaking cement with possible spinal cord or nerve root compression and venous and pulmonary embolism. Patient selection is very important and is discussed below.