Percutaneous vertebroplasty (PVP) is a new minimally invasive technique for the spine that uses percutaneous puncture to inject artificial bone into the vertebral body through the pedicle or directly into the vertebral body in order to enhance the strength and stability of the vertebral body, prevent collapse, relieve low back pain, and even partially restore the height of the vertebral body (1). In recent years, PVP has been gradually promoted for patients with vertebral hemangioma, myeloma, osteolytic metastases and osteoporotic vertebral compression fractures combined with intractable pain, which has the effect of increasing vertebral body strength, stabilizing the vertebral body and relieving pain. Indications and contraindications of VP. Mastering the appropriate indications is the key to achieving good results with PVP, which is mainly used to treat pain caused by vertebral compression fractures or tumor infiltration from various causes and increase vertebral body strength, but cannot relieve symptoms of nerve root or spinal cord compression, nor can it inhibit tumor growth. Whether to choose PVP treatment alone in treatment or to apply surgery, radiotherapy or drug therapy in combination is affected by various factors and should be considered comprehensively. Indications Osteoporotic vertebral fractures According to statistics, 500,000 cases of aging-related vertebral compression fractures occur in the United States each year and cause persistent low back pain; 25% of postmenstrual women have vertebral osteoporotic compression fractures, most of which are accompanied by varying degrees of thoracolumbar vertebral fractures, 10% of postmenstrual women have significant collapse visible on X-ray, and 84 The majority of these fractures were associated with varying degrees of thoracolumbar vertebral fractures, 10% of postmenstrual women had significant collapse on X-ray, and 84% of those with compression collapse of the vertebral body visible on X-ray had low back pain and 4% of postmenstrual women had neurological symptoms. Spinal compression fracture is one of the important complications of osteoporosis, and low back pain is the main symptom. Although the symptoms can be relieved by rest, drugs or traditional surgical treatment, most drugs have adverse effects, while traditional surgical treatment is more invasive and the internal fixation of the osteoporotic vertebrae is not secure, and even if internal fixation is done, the fixed segments have to be long and fixed to the T4 level, which is obviously unacceptable. Posterior spinal osteotomy orthopedics for vertebral body kyphosis is also generally not considered because it is too traumatic, so PVP is undoubtedly a better choice for patients with more activity or older age. Vertebral tumors Vertebroplasty was first used for vertebral tumors and has achieved excellent results. The main tumors it is used for are: vertebral hemangioma, myeloma, metastatic malignant tumors of the vertebral body and primary malignant tumors. Benign tumors of the vertebral body are indications for vertebroplasty as long as they are painful due to fracture collapse of the vertebral body, including eosinophilic granuloma and vertebral body lymphoma. Localized vertebral body resection and reconstruction for metastatic cancer often results in local tumor spread, which is not tolerated by the patient’s systemic condition; myeloma is often multifocal and cannot be fused with multi-segmental resection, and radiation therapy often relieves or eliminates pain in 90% of patients only 10-14 days after the start of treatment, and radiation therapy weakens bone reconstruction, which often starts only 2-4 months after radiation therapy. Especially in patients with myeloma, there is an increased risk of vertebral collapse and consequent nerve compression after radiation therapy. In contrast, PVP provides immediate pain relief and increases the strength and stability of the spine. The majority of spinal hemangiomas are asymptomatic benign lesions, but individual hemangiomas invade the vertebral body more severely, causing microfractures or significant collapse of the vertebral body, causing pain or compression of the nerve or spinal cord, and PVP can increase the strength of the vertebral body, relieve pain, and embolize the tumor. If necessary, posterior decompression of the vertebral plate can be performed, which simplifies the operation without vertebral body resection. For malignant tumors of the vertebral body, as long as they are osteolytic, PMMA can be injected into the vertebral body to obtain stability in addition to simultaneous tumor biopsy. Through the thermal and toxic effects of PMMA, it also has a better effect of killing tumor cells. The relative contraindications are: extensive bone destruction of vertebral body with incomplete posterior margin; vertebral body compression of more than 75%; vertebral body collapse or tumor spread resulting in dural sac and nerve root compression; osteogenic metastases.