Who is a Candidate

Those most likely to suffer from vertebral compression fractures are elderly individuals, typically women with osteoporosis or patients on long term steroid therapy. Additionally, patients with tumors primarly involving the bone marrow, such as multiple myeloma, are known to have an increased incidence of vertebral fractures. The fractures are caused either by the growth of a plasmacytoma in the spine which weakens the vertebral body or by the accelerated bony loss (osteoclastic activity) of the abnormal plasma cells. When the fractures are due to accelerated bone loss, multiple vertebral bodies are usually injured and most of the fractures are located along the vertebral endplates, which decreases vertebral body height. Other systemic diseases such as lymphoma and metastasis are also known to have an increased incidence of vertebral body fractures. Focal tumors of the spine such as a vertebral body hemangioma may also cause vertebral fractures. In these conditions, cementing the damaged bone provides significant pain relief and long term stability of the spinal column.

In other weight bearing areas of the body such as the pelvis, cementing the weaking bone has also been done.  We have treated patients with multiple myeloma with large pelvic lesions for pain relief and for establishing structural integrity to prevent collapse of the hip joint.

Images of the pelvis are visualized on this patient with focal lytic lesion on the left side. After cement deposition the large hole in the bone is filled in, establishing structural integrity and improving pain.

The best indication for vertebroplasty is patients who are experiencing moderate to severe pain from a radiologically confirmed compression fracture that is unresponsive to medical therapy. Best results are obtained on patients who have the fracture for less than 12 months. In selected instances, patients with fractures older than 12 months with refractory pain have also experienced significant pain relief following vertebroplasty.

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