Extreme vertebroplasty: Techniques for treating difficult lesions

For most patients, the standard techniques for performing percutaneous vertebroplasty (PV) work very well. However, for patients with malignant disease causing severe cortical destruction, the usual techniques may be associated with a high incidence of cement extravasation and complications. Osteoporotic patients presenting with very severe vertebral body compression are also a treatment challenge. Certain modifications of the usual techniques may provide a better treatment for both of these types of patients.