Is Insufficient Use of Polymethylmethacrylate a Cause for Vertebroplasty Failure Necessitating Repeat Vertebroplasty?
I wish to compliment Gaughen et al on their continued valuable contributions to the literature as they critically evaluate their vertebroplasty patients. Sharing their experience with others is important to continue to make vertebroplasty an excellent treatment in selected patients. In this article (1), the authors stress the point that they can perform a second vertebroplasty on previously treated vertebral levels as their major emphasis. They also mention that one possible cause for re-treatment resulted from inadequate cement deposition. Although they mention the fact of potential inadequate cement deposition, this feature in the article is not prominently mentioned or emphasized. In their article, there are several cases where polymethylmethacrylate (PMMA) is instilled with very small volumes (1 3.5 mL). These are extremely small amounts of PMMA, unless one is dealing with a severe vetrabra plana. Because many of these patients have osteoporosis, if PMMA is placed in only a small p
