This phase of the procedure is controlled under strict lateral fluoroscopy. The injection of acrylic glue is stopped immediately whenever an epidural or paravertebral opacification is observed in order to prevent spinal cord compression. When vertebral filling is insufficient, a contra-lateral injection is suggested in order to complete the filling. After the vertebral filling, the mandrin of the needle is replaced and the needle is removed before the cement begins to set. Six to seven minutes after mixing, the polymethylmethacrylate begins to harden. During this hardening time, the polymethylmethacrylate becomes hot (in some cases up to 90°C). The patient should be under neuroleptanalgesia to control pain. Monitoring of the arterial pressure is necessary during the procedure because polymethylmethacrylate injections can induce brief drops in arterial pressure. Total procedure time ranges from 20 to 50 minutes. In patients with osteoporosis and symptomatic hemangioma, an optimal filling (2.5 - 4 ml) of the vertebral body is required to obtain both effects of percutaneous vertebroplasty: consolidation and pain relief. In patients with tumoral pathologies, percutaneous cementoplasty is usually performed for excruciating pain. In these cases, a low volume (1.5 - 2.5 ml) of acrylic glue allows good pain relief.
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Vascular Interventions
Injection of the cement
