• Giovanni Andrea La Maida, Laura Serena Giarratana, Alberto Acerbi, Valentina Ferrari, Giuseppe Vincenzo Mineo, and Bernardo Misaggi.
• Spine Surgery Division, Gaetano Pini Orthopaedic Institute, Piazza Cardinale Andrea Ferrari 1, 20122 Milan, Italy. giovanniandrea.lamaida@gpini.it
• Eur Spine J. 2012 May 1;21 Suppl 1:S61-8.

PurposeTo evaluate and address the safety of vertebroplasty (VP) and kyphoplasty (KP) in terms of rate and type of cement leakage in the treatment of Multiple Myeloma (MM) vertebral fractures.MethodsA total number of 37 treated vertebrae were evaluated post-operatively by using standard X-rays and CT scan looking for a cement leakage. VP was done using a monoportal approach in all cases (18 treated levels, group A), while KP was done using a monopedicular approach in 9 levels (group B1) and using a bipedicular approach in the remaining 10 levels (group B2). A computed tomography was used to establish the presence of any cement leakage and to determine its localization.ResultsVertebral augmentation through VP and KP provides immediate pain relief and an improvement of the quality of life of patients affected by MM but it is gravated by high risk of cement leakage. Cement extravasation occurred in 27.7% of total VP procedures and in 21.05% of total KP procedures, but considering the whole number of treated levels, it was more common in multi-level VP and in bipedicular KP, in which a higher quantity of cement was employed.ConclusionsKP procedure in these patients is slightly less risky but we suggest doing it with a monopedicular approach. It's mandatory to use an high viscosity cement and we suggest not to use an amount of PMMA over 2 cc and a previous treatment with bone marrow transplant is related to a lower risk of cement leakage.

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