The Technique for Vertebroplasty

1. Vertebroplasty in Benign and Malignant
Disease
Kieran J. Murphy MD, FRCPC
Associate Prof. Radiology and Neurosurgery
Director of Interventional Neuroradiology
Johns Hopkins Medical Institution.

2. Definition
• The percutaneous injection of bone cement into a
symptomatic vertebral body.

6. The ideal patient
Recent and isolated fracture
Mild to moderate loss of vertebral height
No degenerative disease

7. Careful positioning

8. The real patient
Multiple and old fractures
Severe loss of vertebral height (vertebra plana)
Extensive degenerative disease

9. Prone is not always possible

10. Inclusion criteria
• Pain resistant to medical management.
• We have no age limit
• We have no height requirement
• We have no time limit from the fracture.

11. Exclusion criteria
• Infection
• Coagulopathy

17. Bilateral Transpedicular
Vertebroplasty
• The safest method in the beginning of your
experience.

19. The Single Pedicle Approach
• The needle is passed from a lateral position on the
pedicle to arrive at the midline of the vertebral
body

28. Trans oral C2 vertebroplasty in a man who
was wrestling with his son and broke his
C2 . Its called the hangmans fracture)

33. Today, 23 years after
the first Sundance
meeting
Vertebroplasty and
kyphoplasty is a 10
Billion a year
business.
Medtronic is the
biggest player. The
purple boxes in the
image of our spine
hshelp are theirs.
The blue and orange
boxes are my stuff.

34. Vertebroplasty is a cheap cost effective
procedure that brings great pain relief.
It costs about 800 dollars per patient.