PRINCIPLES AND MECHANISMS OF ACTION OFVERTEBROPLASTY:Vertebroplasty is a therapeutic procedure in which the bone cement is injected into a vertebral body to consolidate it and to obtain an analgesic effect. Its main objective is to improve the quality of life of patients. The main indications are the the treatement of vertebral angioma, osteoporotic and malignant fractures. The material used is polymethylmethacrylate (PMMA).The procedure is performed under local or general anesthesia percutaneously. Radiological control intraoperative (fluoroscopy or CT) is necessary, usually by transpedicular approach ,Absolute contraindications are local infection, spinal corde compression and the posterior wall ruptures of the injured vertebrae.Kyphoplasty is a therapeutic alternative in case of posterior wall rupture. it is a similar method to vertebroplasty except that the cement is injected into a balloon inflated in the vertebral body. The main incidents are the cement leakage into the veins, disks or soft tissue. Some complications such neurological deficit and pulmonary embolism are exceptional. The results are very satisfactory. The pain quickly regresses and disappears in most cases.The profit is maintained in long term. The height of the vertebral body is partially restored. The best results were observed in benign pathology (vertebral angioma settlements and osteoporosis). This vertebroplasty also has a local antitumor effect. The follow-up showed no recurrence or local metastatic invasiveness. Vertebroplasty is a mini-invasive procedure, simple and effective with promising results for the treatment of vertebral fracture. It provides significant pain relief with the potential for improving functional outcome.
OBJECTIVES OF THE STUDY:Our work is a retrospective study about 15 cases of vertebral fracture admitted Between January 2011 and June 2014 in the neurosurgery department of the CHU Mohammed VI of Fez. Our goal is to study the epidemiological, clinical and radiological vertebral compression fractures supported in the departement, but mainly to share our experience in in the treatment of vertebral compression fractures, osteoporosis and metastatic by percutaneous vertébroplasty.The serie includes 7 men (46.7%) and 8 women (53.3%) whose ages ranged between 23 and 86 years with an average of 61.3 years. The causes are dominated by domestic accidents (66.7%), comes after, the highway accidents (20%). Clinically, The rachidian pain is the main revealer sign. all of our patients had no deficit and accusing only spinal syndrome, they have all benefited from radiographs and scans. Magnetic resonance imaging was achieved in 9 of our patients (60%) The lumbar compression fractures are predominate (46.7%) with elective seat at the level of the first lumbar vertebrae. The etiologies are variables: the osteoporotic compression fractures are the most common (7cases) (46.7%), followed by the post traumatic causes (4cases (26.7%). The evolution is satisfactory overall with significant pain relief and good spinal stability