Percutaneous polymethylmethacrylate vertebroplasty: technique and imaging

Objective: The study was designed to describe the technique for percutaneous polymethylmethacrylate (PMMA) vertebroplasty and the pattern of PMMA imaging distribution. Methods: Fifteen fresh lumbar vertebrae bodies (VBs) were separated into three groups and 8 ml PMMA was injected into each specimen, respectively, with the thickness of 1:1 (n = 6), 2:3 (n = 6), 1:2 (n = 3), to observe the leakage of PMMA. Five cadaveric thoracolumbar spines were harvested. Under CT control, percutaneous puncture of the involved vertebrae was performed via a trans-pedicular approach, followed by injection of PMMA. The capacity and thickness of PMMA were recorded and the pattern of PMMA distribution was observed. All spines were separated into individual vertebrae to observe the leakage of PMMA. Eight VBs were augmented with PMMA to measure the central temperature of PMMA. Results: The leakage of PMMA was found in all VBs augmented with 1:1, while only one was found in 2:3, and 2:3 was the most suitable thickness. The procedure was technically successful in all specimens, with an average injection amount of 9 ml PMMA per vertebral body. PMMA was distributed all over the vertebrae. The leakage of PMMA was present in 2 specimens' post vertebral sinus. The highest temperature was 48 degree C. Conclusion: Percutaneous PMMA vertebroplasty is a valuable clinical therapeutic method in spine angiomas, metastases, and osteoporosis