Biomet Cementing University

Prof Jacques Chiras

Jacques Chiras
Professor
Department of Neuroradiology
Pitié Salpêtrière hospital
Paris, France

The technique of percutaneous vertebroplasty
Percutaneous vertebroplasty is a technique for addressing vertebral body compression fractures that are refractory to medical therapy. Vertebroplasty is a minimally invasive procedure providing pain relief and aiding spinal stabilisation in most cases.

Stabilisation of the vertebral body
The percutaneous vertebroplasty technique strengthens the vertebral body weakened by bone disease with an injection of bone cement into the vertebrae. For the cervical spine, an antero lateral approach is used, while for thoracic or lumbar vertebra, the approach is usually transpedicular. Main indications are spine angiomas, metastases and osteoporosis. For metastases, the technique can be useful in reducing recurrent pain after chemotherapy and/or radiotherapy and also in stabilising vertebra before radiotherapic or chemotherapic treatment (either isolated or in combination with surgical osteosynthesis). For osteoporosis, it can help reduce refractory pain that is present despite medical treatment.

Injection of PMMA bone cement
Percutaneous vertebroplasty is a radiological procedure for introducing bone cement into vertebral bodies in order to mechanically strengthen the structure. Injection of the PMMA cement should be performed under continuous fluoroscopic monitoring to prevent extravasation and potential complications. Proper patient selection and solid cementing technique will minimise complications. Percutaneous vertebroplasty requires high-calibre imaging equipment and a well-trained staff. Clinical results have shown that this vertebroplasty can provide significant pain relief with very low complication rates.

Training in vertebroplasty
Local sessions including live procedures and courses are frequently organised by the Department of Neuroradiology. Fellowship organisation of sessions can also be provided.