Osteoporosis and osteoporotic fractures are a growing medical and social problem, and the spine is the most common site for osteoporotic fractures to occur.Fractures can present three basic problems, i) acute fracture of a single segmented vertebra, ii) multisegmental vertebral fracture with collapse and loss of normal balance and posture in the sagittal plane, and iii) multisegmental vertebral fracture with secondary spinal stenosis and nerve compression. . Depending on the problems that arise, different treatments should be taken. In recent years, with the development of minimally invasive techniques, vertebroplasty has received more and more attention, and the technique of vertebroplasty using perfusion agents for the treatment of osteoporosis has been rapidly developed because of its precise effect. In 1984, Deramond in France first applied percutaneous injection of bone cement (polymethylmethacrylate) into the vertebral body to successfully treat a patient with C2 vertebral hemangioma who had chronic pain, and this procedure was called percutaneous vertebroplasty (PV). Duquesnel first applied PV to treat vertebral compression fractures caused by osteoporosis or malignant tumors. in 1994, PV began to be applied in the United States, and has been gradually spreading in recent years. It provides a great development prospect for the treatment of osteoporotic fractures. Indications and contraindications Mastering proper indications is the key to good results of PV. PV is mainly used to treat vertebral compression fracture or pain caused by tumor infiltration and increase the strength of the vertebral body, but it can’t alleviate the symptoms of nerve root or spinal cord compression, and it can’t inhibit the growth of the tumor. Whether to choose fold pure PV treatment or combined application of surgery, radiation therapy, and drug therapy in the treatment is affected by many factors and should be considered comprehensively. Osteolytic metastases and myeloma of the spine are the main indications for PV. Patients often have severe pain, and vertebrectomy + reconstruction can treat focal lesions, but lesions are often multifocal,. Radiotherapy often results in pain relief or disappearance in more than 90% of patients only 10-14 days after the start of treatment. However, radiotherapy weakens the ability of bone reconstruction, which often begins 2-4 months after radiotherapy, especially in patients with myeloma, and tends to cause vertebral collapse, which increases the risk of nerve compression. PV provides immediate pain relief and increases the strength and stability of the spine. Vertebral hemangiomas are mostly asymptomatic benign lesions, and when they cause pain, vertebroplasty can be performed. Osteoporosis sign of vertebral collapse caused by pain after rest, most of the improvement after drug treatment, ineffective, the feasibility of vertebroplasty treatment. This is especially true for patients who are more active or older. Hospitals unconditional to perform acute decompression of the spinal canal, patients with coagulation mechanism disorders can not perform vertebroplasty. When the vertebral body is widely damaged and the height of the vertebral body is less than 1/3 of the original, the operation of vertebroplasty is difficult. Preoperative examination and preparation 1, preoperative examination and combined with imaging examination to determine the site of the affected vertebra. In the acute stage of fracture, MRI examination of sagittal T1-weighted image can be seen in the nucleus pulposus signal weakening. Bone scan can see enhanced radionuclide activity. 2, preoperative routine X-ray and CT examination, if necessary, MRI examination, in order to assess the degree of vertebral body collapse, site and scope, the situation of vertebral arch root visualization, the vertebral cortical posterior wall is intact. And whether there is epidural or intervertebral foraminal stenosis due to bone mass. 3.Preoperative application of antibiotics to prevent infection. Efficacy More than 90% of patients with osteoporosis have significant pain relief or disappearance. Pain relief or disappearance usually occurs a few hours or days after surgery, on average within 24 hours. Sometimes the pain is relieved after a transient aggravation. PMMA polymerization prevents the vertebral collapse from worsening or forming new collapses, and most patients are able to get out of bed and move freely on the second day after surgery. Mechanism of action The mechanism of PMMA injection for pain relief is not fully understood. Possible mechanisms are 1, mechanical, chemical, thermal effects and other factors may cause the destruction of nerve endings in the tissue surrounding the lesion, so as to achieve the effect of pain relief. 2.Infusion injection can enhance the strength of the lesion vertebral body, so that the microfracture can be fixed, and at the same time, reduce the stress, so as to achieve the effect of pain relief.