Percutaneous transpedicular polymethylmethacrylate vertebroplasty for the treatment of spinal compression fractures

Neurosurgery. 2001 Nov;49(5):1105-14; discussion 1114-5.


Objective: To assess the safety, feasibility, and clinical outcome of percutaneous transpedicular polymethylmethacrylate vertebroplasty (PTPV) for the treatment of spinal compression fractures causing refractory pain.

Methods: We retrospectively reviewed a consecutive group of patients undergoing PTPV at our institution between April 1998 and January 2001. Outcome measures included analgesic requirements, ambulatory status, sleep comfort, and overall quality of life 2 weeks after the procedure.

Results: A total of 97 patients (73 women and 24 men) underwent 258 PTPV procedures during 133 treatment sessions. The mean age was 76 years (range, 42-99 yr). The mean duration of follow-up was 14.7 months (range, 2-35 mo). Most of the patients had osteoporotic compression fractures, although some had osteolytic malignancies. Complete follow-up was obtained in 81 patients (84%). Narcotic and analgesic usage decreased in 63% of patients, increased in 7%, and remained the same in 30%. Ambulation and mobility were improved in 51%, worse in 1% and the same in 48%. One-half of the patients were able to sleep more comfortably after the procedure, whereas the other half remained the same. Most patients who reported no change in sleep or ambulation had experienced no impairment of these activities before PTPV. Overall, 74% of patients believed that PTPV significantly enhanced their quality of life and 26% reported no change. No patient was worse after PTPV. One patient with preexisting pneumonia died of respiratory failure after the procedure; another died of an acute stroke weeks later. One patient developed symptomatic pulmonary embolism of cement, and another developed transient quadriceps weakness from radiculopathy. Other complications were minor and infrequent. There were no infections.

Conclusion: PTPV provided significant relief in a high percentage of patients with refractory pain. PTPV is a safe and feasible treatment for patients with spinal compression fractures.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fractures, Spontaneous / diagnostic imaging
  • Fractures, Spontaneous / surgery*
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / injuries*
  • Lumbar Vertebrae / surgery
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Neurologic Examination
  • Pain Measurement
  • Polymethyl Methacrylate / administration & dosage*
  • Postoperative Complications / diagnostic imaging
  • Radiography
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / surgery*
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / injuries*
  • Thoracic Vertebrae / surgery
  • Treatment Outcome


  • Polymethyl Methacrylate