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Vertébroplastie

  • Chapter
Métastases vertébrales

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Abstrait

Les premières vertébroplasties ont été imaginées pour traiter des angiomes vertébraux agressifs (8, 12). Puis rapidement, l’efficacité antalgique de cette méthode a été également démontrée pour les envahissements tumoraux et les fractures par insuffisance osseuse du corps vertébral (6, 9, 17). L’injection intracorporéale, par voie percutanée, de ciment acrylique consolide et stabilise le corps vertébral pathologique (9). Le ciment permet une transmission et une répartition des contraintes et procure une stabilité immédiate autorisant une reprise précoce de l’appui. Même un remplissage partiel peut être bénéfique; il a été démontré que le comblement d’un seul côté du corps vertébral n’induisait pas de risque de tassement du côté non consolidé (26). L’effet antalgique provient aussi de la consolidation de microfractures de l’os sain avoisinant la tumeur (17) et de la nécrose de contact des terminaisons nerveuses sensibles périostées (17, 30) induite par la toxicité chimique et le dégagement thermique obtenu lors de la polymérisation du ciment (80°). Ce dernier mécanisme est probablement très relatif : il a été démontré sur des animaux (35) que la température moyenne à l’interface ciment-tissu osseux n’augmentait que peu (44°6).

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Authors and Affiliations

  1. Institut Bergonié, 229, cours de l’Argonne, 33076, Bordeaux Cedex

    Jean Palussière (Radiologue)

  2. Hôpital Pellegrin-Tripode, 1, place Amélie Raba-Léon, 33076, Bordeaux Cedex

    Vincent Dousset (Neuroradiologue)

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  1. Jean Palussière
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Editors and Affiliations

  1. Service de Chirurgie Orthopédique et Réparatrice, Hôpital Pellegrin-Tripode, Place Amélie-Raba-Léon, 33076, Bordeaux Cedex

    Vincent Pointillart

  2. Service d’oncologie médicale, Hôpital Saint-André - CHU Bordeaux, 1, rue Jean Burguet, 33075, Bordeaux Cedex

    Alain Ravaud

  3. Institut Bergonié, 229, cours de l’Argonne, 33076, Bordeaux Cedex

    Jean Palussière

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© 2007 Springer-Verlag France, Paris

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Palussière, J., Dousset, V. (2007). Vertébroplastie. In: Pointillart, V., Ravaud, A., Palussière, J. (eds) Métastases vertébrales. Springer, Paris. https://doi.org/10.1007/978-2-287-33744-4_32

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  • DOI: https://doi.org/10.1007/978-2-287-33744-4_32

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-33743-7

  • Online ISBN: 978-2-287-33744-4

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