Vertebroplasty technique
The patients were transferred to the IR suite, were intubated, and received general anesthesia. They were positioned prone on the fluoroscopy table and the skin of the back prepped and draped as per standard sterile technique. Using biplanar fluoroscopic-guidance, the interventional radiologist advanced a 13-gauge or 15-gauge bone needle via a costrotransverse (for thoracic vertebral bodies) or transpedicular (for lumbar vertebral bodies) approach using a surgical mallet, into the midline of the anterior third of the targeted vertebral body, following previously described technique in adults 7. Under continuous fluoroscopy, the polymethyl methacrylate (PMMA) cement was injected. Care was taken to ensure no cement extravasated beyond the margins of the vertebral body, especially into the spinal canal, or into the venous system. After achieving adequate distribution within the vertebra and waiting the necessary time for polymerization of the cement, the needle was removed. Patients recovered in the acute care unit for 4-6 hours to recuperate from anesthesia and then were transferred to the general ward for overnight observation with discharge the following morning.