Minimally invasive orthopedic surgery – percutaneous vertebroplasty

  Vertebroplasty (PVP) is a percutaneous (without skin incision) injection of bone cement into the vertebral body under the surveillance of imaging equipment to increase the strength of the vertebral body, stabilize the diseased vertebral body and prevent its collapse, thus providing pain relief. It is mainly used for the treatment of osteoporotic compression fractures in the elderly, and also for the treatment of myeloma and metastases. Based on this technique, balloon vertebroplasty (PKP) has also been developed, which means that the collapsed vertebral body is first expanded using a balloon to push out the adjacent bone, creating a space within the vertebral body, and then injecting bone cement to restore the height of the vertebral body and increase its strength. The operation is safe (complication rate 0-10%,), the operation time is short (operation time about 30 minutes), the patient recovers quickly (can go down to the ground about 5 hours after the operation), and the operation effect is obvious (the pain relief efficiency is about 60%-100%).  Treatment mechanism: (1) Mechanical strength increases the supporting effect: the bone cement injected into the fracture site rapidly hardens and then plays a supporting role for the fracture site. (2) Thermal analgesic effect: the temperature of the bone cement at the fracture site can be as high as 82℃ during the hardening process, and this thermogenic effect can cause necrosis of some adjacent nerve endings, thus producing an analgesic effect. (3) Decompression of the punctured fracture part to relieve the pain caused by bone marrow hypertension. (4) The toxic effect of the bone cement itself damages the local nerve endings and relieves pain by decreasing the sensitivity of the nerve endings. (5) In the treatment of bone metastases, the mechanical compression effect produced by the injection of bone cement partially or completely cuts off the blood supply to the tumor, thus accelerating the necrosis of the tumor tissue. In addition, the thermal effect of bone cement can kill some of the tumor cells, greatly improving the quality of life of tumor patients.