Only recently, vertebroplasty (VP) and kyphoplasty (KP) were introduced in the treatment of lesions of the vertebral body (VB). Most frequently, osteoporotic fractures (VP, KP) and metastases (VP) are treated in highly selected patients. These methods consist of polymethylmethacrylat (PMMA) injection into the VB usually through transpedicular canulas. In KP a coaxial balloon creates a cavity within the vertebral body, thus restoring some of the original VB height before cement injection. Consistently, these methods result in favourable outcomes. However, because of possible cement leakage and subsequent neurocompression with permanent damage, we advocate our surgical approach with prophylactic interlaminar fenestration prior to VP.
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