In 1984, French scholars such as Galibert first used percutaneous vertebroplasty (PVP) to treat cervical spondylolisthesis with good pain relief, and first reported this technique in 1987, and further proposed in 1990 that this technique could be used for the treatment of myeloma, metastases, and osteoporotic fractures, and thus the PVP technique was widely used.
Currently PVP with posterior kyphoplasty (PKP) is used overwhelmingly for the treatment of vertebral compression fractures of various causes, with the following common primary diseases.
① Osteoporosis: Since more than half of the elderly over 60 years of age have varying degrees of osteoporosis, in recent years PVP and PKP treatment has been mainly applied to compression fractures caused by osteoporosis;
②Metastatic tumors;
③Myeloma;
④Invasive hemangioma;
⑤ traumatic compression fractures.
It is generally believed that there are no absolute contraindications to PVP and PKP, while the relative contraindications are.
①Vertebral compression exceeding 75%;
(ii) burst fractures or involvement of the posterior border of the vertebral body;
(iii) osteogenic metastases;
④Severe cardiovascular disease or poor physical condition that cannot tolerate surgery.
The efficacy of PVP and PKP is mainly reflected in the following aspects.
①release or alleviate pain and significantly improve the quality of life of patients.
②Restoration of vertebral body height to different degrees.
③ Correcting the posterior convexity deformity.
④Cure most of the hemangiomas. Among them, the improvement of pain symptoms is the most obvious, especially for fresh osteoporotic compression fractures where the efficiency is between 90-100%.
The incidence of complications between PVP and PKP is very low, about 0-10%, and is mainly seen in the following areas.
(1) Bone cement leakage, which occurs most frequently. The leakage is caused by the puncture needle breaking through the inner edge of the pedicle or the posterior edge of the vertebral body, over-injection of bone cement, too thin bone cement, etc. Most of them do not cause obvious symptoms, but a few of them can cause neurothermal injury or spinal cord and nerve root compression symptoms, and surgery should be performed to remove the bone cement when the leakage is large and the symptoms are obvious.
②Nerve root thermal injury, mostly caused by the leakage of bone cement, occurs less frequently and mainly causes short-term pain aggravation, which can generally be relieved by appropriate medication.
③Pulmonary embolism is rare and is mostly caused by leakage of bone cement.
Compared with PVP, the incidence of cement leakage is significantly lower because the former forms a cavity through balloon expansion and the injection pressure is lower.