Percutaneous vertebroplasty/balloon expansion kyphosis orthopedics Back pain plagues many patients, most of whom suffer from vertebral compression fractures associated with osteoporosis, and some cases arise from benign or malignant tumors of the vertebral body. Our department performs percutaneous vertebroplasty/balloon dilatation retrobulbar deformity orthopedic surgery without incision. A bone cement called polymethylmethacrylate (PMMA) is injected into the unchanged vertebral body from the back under X-ray guidance, which not only rebuilds the strength of the spine but also achieves pain relief. The procedure is performed under local anesthesia and is a truly minimally invasive technique, allowing even frail patients to receive this treatment. Using this technique, more than 10,000 cases are currently treated each year in the United States, and it has become the treatment of choice for vertebral compression fractures. The treatment results in 95% pain relief and functional recovery, and the procedure is safe, fast-acting and long-lasting, unmatched by traditional treatments (such as open surgery, traction, anti-inflammatory or narcotic pain medication, etc.). Vertebral compression fractures caused by osteoporosis China has entered an aging society, according to statistics, the population over 65 years of age has exceeded 90 million, and this number will continue to increase with the development of society. It is estimated that 40% of these people will experience an osteoporosis-related vertebral fracture during their lifetime. The pain caused by vertebral fractures can lead to loss of labor and motion, further bone loss due to prolonged bed rest, and further worsening of osteoporosis, creating a vicious cycle. If the condition persists without improvement, it can cause fatal complications such as loss of limb motor function, pulmonary atelectasis and pneumonia, deep vein thrombosis and pulmonary embolism. Vertebral compression fractures are also an important reason why many elderly people are unable to care for themselves and lose their ability to live independently. The use of large amounts of medication often causes drug toxicities as well as drug dependence and can cause further aggravation of osteoporosis. Pain caused by malignant tumor of vertebral body Malignant tumor invades vertebral bone and causes pathological fracture, or severe pain, which often makes patients feel worse than death. Metastatic malignant lesions are the most common type of spinal tumor, with primary foci dominated by malignant tumors such as lung, liver, and breast cancer; hematologic malignancies such as multiple myeloma and lymphoma also often involve multiple vertebrae. Previous treatment was based on powerful analgesic therapy, but the toxic side effects of drugs cannot be ignored. How to make patients suffer less pain and improve their quality of life in their limited life has been a difficult problem for oncologists. Percutaneous vertebroplasty is a simple and effective method to solve this dilemma. Studies have shown that bone cement injected into the tumor-invaded vertebral body can bridge pathological fractures and strengthen the bone. Heat is released when the bone cement polymerizes, bringing the temperature of the surrounding tissue to 90°C, killing tumor cells and damaging painful nerves. Vertebroplasty is the least invasive and most effective treatment method among the various means currently available for treating vertebral malignancies. Percutaneous vertebroplasty for vertebral hemangioma Vertebral hemangioma is a benign disease of vascular origin. Vertebral hemangiomas that are in a stable state are asymptomatic and do not necessarily require treatment. In contrast, infiltrative vertebral hemangiomas gradually involve the vertebral body and extend into the vertebral arch, resulting in collapse of the vertebral body and the formation of a soft tissue mass. The fracture and occupying effect caused by this disease leads to persistent severe back pain due to compression of the sheath capsule or involvement of the neural foramina. Vertebral hemangiomas often occur in young and middle-aged people and result in limited motion and loss of earning capacity. Surgical procedures often result in significant bleeding and surgery (vertebral body resection and graft placement) is very difficult, so radiotherapy was used in the past in most cases, but radiotherapy only provides transient relief and recurrence of symptoms occurs in almost all cases. Percutaneous vertebroplasty is currently the only effective way to eradicate vertebral hemangiomas, with an efficiency rate of almost 100%. By injecting bone cement into the hemangioma through a steel needle, on the one hand, the hemangioma can be controlled by sealing the vascular lesion with the bone cement; on the other hand, the cement greatly strengthens the vertebral body after solidification, which can effectively prevent nerve compression and painful symptoms caused by pathological vertebral body collapse. Surgical technique Percutaneous vertebroplasty technique: The bone cement is directly injected into the diseased vertebral body to strengthen the vertebral body and relieve pain. It is suitable for mild vertebral fractures caused by osteoporosis and pain caused by simple tumors (no vertebral fractures). Balloon expansion vertebroplasty technique: for patients with severe vertebral compression and kyphoscoliosis (humpback). Before the bone cement is injected into the vertebral body, the compressed vertebral body is first propped up with a special balloon to restore the shape and then inject the bone cement to correct the spinal deformity. Both techniques can be performed under local anesthesia and are truly minimally invasive procedures that are less painful for the patient, who can be out of bed within a few hours after the procedure.