HISTORY AND DEVELOPMENT
Many years vertebroplasty is used as an open procedure to augment pedicular screw fixation during spinal instrumentation. The history suggests that the procedure was performed by Galibert and Deramond in the department of Radiology of the university hospital of Amiens, France.[Galibert P, Deramond H, Rosat P, et al. Preliminary note on the treatment of vertebral haemangioma by percutaneous vertebroplasty. Neurochirugie 1987;33:166–168 (French).] In 1984, on a 54 years woman who had severe neck pain with radiculopathy of C2 nerve root. The X-rays showed large vertebral haemangioma involving the C2 vertebral body. The C2 vertebra was injected percutaneously PMMA by a 15 G needle by an anterolateral approach. The patient had complete pain relief. Subsequently 6 patients were tried and the outcomes were published in 1987. Much experience was gained from the experimental work conducted on the fresh cadavers which could establish the technical parts of the procedure. On the basis of the work following points were established:
- Large bore 10 G needle can be used for the lumbar and thoracic vertebrae. Cervical spine would require 15 G needle.
- Addition of Tantalum to the cement [PMMA] to facilitate fluoroscopic visualisation of the cement during injection.
Later on the other doctors from the university hospital, Lyon, France used this surgery for weakened osteoporotic vertebrae of seven patients and in one with metastatic lesion and out of them six reported excellent results and one reported good results for pain relief. This procedure eventually was popularised in USA for vertebral compression fractures. [Jensen ME, Evans AJ, Mathis JM, et al. Percutaneous polymethyl methacrylate vertebroplasty in the treatment of osteoporotic vertebral fractures. Technical aspects. Am J Neuroradiol 1997;18:1897–1904].