Vertebro-/kyphoplasty history, development, results

Many investigations prove the significant analgetic effect of vertebral augmentation. The reasons for the decrease in pain are found in the stabilization of fracture fragments as well as the toxic-thermic effect of polymethylmethacrylate (PMMA), used in the majority of cases. The techniques, primarily in use since 1984, can be divided in vertebro- and kyphoplasty. Vertebroplasty is the direct injection of PMMA into the trabecular vertebral body, while kyphoplasty uses an inflatable bone tamp to create a cavity which is filled with highly viscous cement allowing a certain degree of vertebral height restoration. Both techniques are used percutaneously. Indications for augmentation are painful osteoporotic vertebral fractures, metastatic osteolyses, and painful or destabilizing vertebral hemangiomas. In this article, an overview of the techniques and the history of their development is provided. The materials used for augmentation, the possibilities, limits, and complications of the techniques are discussed. © Urban & Vogel.