Las técnicas de refuerzo vertebral, vertebroplastia y cifoplastia, consisten básicamente en la introducción de un cemento óseo -polimetilmetacrilato (PMMA)- en un cuerpo vertebral fracturado, para aliviar el dolor mediante la estabilización de la fractura vertebral. En ocasiones, previamente a la administración del cemento, a nivel de la vértebra colapsada, se inserta un balón que se insufla con la finalidad de restaurar la altura del cuerpo vertebral y reducir la deformidad cifótica; en estos casos hablamos de cifoplastia o de vertebroplastia mediante balón.
Las indicaciones de la vertebroplastia y cifoplastia han ido evolucionando, pasando de la estabilización de una fractura vertebral osteoporótica dolorosa, al refuerzo de un colapso vertebral secundario a metástasis.
En el presente trabajo se revisan los principales aspectos técnicos de la vertebroplastia y de la cifoplastia, a la luz de nuestra experiencia en el tratamiento de las fracturas vertebrales.
Se necesitan más estudios que permitan definir el papel de cada procedimiento dentro del arsenal terapéutico de la cirugía de columna.
The intravertebral injection of acrylic resin cement -usually polymethylmethacrylate (PMMA)- into a fractured vertebral body, constitutes the basis of the so called “vertebral augmentation techniques”, “vertebroplasty” and “kyphoplasty”, to manage pain and to strengthen and stabilize the compromised vertebra.
In some ocassion, prior to the PMMA injection, an inflatable bone tamp was inserted into both pedicles of the fractured vertebra with the aim of restoring vertebral height to correct the kyphosis deformation. This procedure is called kyphoplasty (balloon-assisted vertebroplasty).
The indications for vertebroplasty and kyphoplasty are evolving, from stabilization of painful osteoporotic vertebral fractures to vertebral collapse secondary to spinal metastases.
In this paper we review the technical basis of both procedures, according to our experience in the treatment of vertebral fractures. Further studies are required to define the role for each techniques in the spinal surgery's armamentarium.
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