One technique of percutaneous vertebroplasty

PVP necessity and theoretical treatment of osteoporotic compression fractures with osteoporosis based aging society also appears more and more, mostly aged over 60 years, due to its metabolism elderly weakened bone formation decline, minor trauma can occur compression fractures can also spontaneously produce fractures. From the perspective of biomechanical point of view, osteoporosis is considered a serious bone mass and strength decrease, the body can not adapt to the exercise load requirements during normal activities spontaneous fractures and back pain can occur, mainly in the vertebrae. Current conventional treatments include bed rest, pain treatment, calcium and hormone application, which can make patients have a greater pain and inconveniences in daily life, bedridden and would further aggravate osteoporosis, resulting in a vicious cycle, and can lead to bedsores, falling occurs plot pneumonia, urinary tract infection, deep vein thrombosis and the like.

With posterior pedicle fixation by the development of thoracolumbar fractures may be posterior vertebral distraction, restore vertebral body height, but traditional surgery trauma, blood loss, surgery for a long time, coupled with the patient osteoporosis, implant screws, gripping force is not strong enough, complications, and because of trabecular bone within the vertebral body support system is destroyed when the squeeze fracture, so at the same height restoration, and trabecular system can not be restored at the same time, produce voids within the vertebral body, the "shell-like" vertebrae, vertebral height restoration due, in good illusion of vertebral reset line X is formed, in fact, has lost structural integrity, non-weight-bearing capacity, and all within fixed are clinically fixed, if not promptly rebuild spinal stability, restore strength and fixation will eventually fail, how to find a small trauma, simple operation, good efficacy in the treatment of new vertebral compression fracture becomes extremely important, the injection into the vertebral body solidified materials such as PMMA, vertebrae get immediate stability, Mermelstein [5] tested standards body biomechanics showed that the pedicle into the vertebral calcium phosphate cement can be injected into the new burst fracture model to enhance the stability of the anterior column, stress reduction and internal fixation. And since vertebroplasty appeared in 1994, first used in the United States after the treatment of osteoporotic compression fractures, because of its good treatment effect, in Europe and America gradually extended.

PVP analgesic mechanism of action of osteoporosis patients will be intractable low back pain, post-traumatic fracture once, the pain is more intense, and after the injection of bone cement, can quickly relieve pain, the mechanism is not fully understood, the general consider the following factors: (1) bone cement injecting its mechanical action of local vascular truncation; thermal effects (2) chemical toxicity and its bone cement polymerization, can kill cells in the peripheral nervous; (3) to strengthen the bone cement injection stability of the vertebral body, which itself is fixed to reduce the role of stress fractures, while reducing the area of vertebral fracture stimulation of nerve pain relief.

Surgical indications and contraindications, complications from vertebroplasty occurred since the indications are mainly concentrated in vertebral hemangiomas, osteolytic vertebral body metastases, myeloma and vertebral osteoporotic vertebral compression fractures, and gradually become the main means of treatment. The contraindications are: Cross the posterior edge of the vertebral bone destruction or vertebral fracture lines, were incomplete, vertebral compression by more than 75%; coagulation disorders, bleeding tendencies; extreme physical weakness, We can not tolerate surgery, osteoblastic metastases and spinal cord compression by persons. As for the complications and complications related to the selection and manipulation techniques, it was reported incidence of 1% to 10%, of which osteoporosis is between 1% to 3%. Are: (1) bone marrow mud spill: it can produce clinical symptoms after the occurrence should be closely observed, do the proper treatment, symptoms of oppression when found, should be treated surgically. However, the complications are rare, the application of the treatment of 258 cases of PVP patients, only four patients required surgical decompression; bone cement spilled into multiple paraspinal no clinical symptoms, but spilled into the pulmonary vein may cause serious complications, Therefore, under fluoroscopic monitoring, this happens immediately stop the injection. (2) local pain worse: can cause local inflammation after PMMA polymerization can occur a few hours after the injection a transient increased pain or fever, usually taking antipyretic analgesics, 2 days after the symptoms can be alleviated. The patients, 2 cases of postoperative pain worsened, were relieved within 24h.

In summary, PVP treatment of osteoporotic vertebral compression fractures, can quickly relieve pain, restore the stability of the vertebral body, it is a simple, safe and effective micro-innovation, technological progress as PVP, believe it there will be a wider range of applications in clinical practice