ANSWER: Osseous metastasis
EXPLANATION:
Posterior and lateral views of the lumbar spine demonstrate moderate L1 anterior wedge compression fractures, with bilateral transpedicular approach cementation of the fractured vertebral body. Prior to these images, the vertebral body lytic lesion was treated with RFA and balloon expansion. Findings are compatible with kyphoplasty.
Vertebral augmentation includes kyphoplasty, vertebroplasty, and sacroplasty. Sacroplasty is cement injection of the sacral body. Verebroplasty is cement injection of usually the thoracic or lumbar spine. Kyphoplasty is a similar procedure to verebroplasty, with the addition of balloon dilatation of the vertebra prior to cementation. Indications include symptomatic, acute-to-subacute vertebral/sacral body fracture and osseous vertebral body neoplasm/metastasis. Complications include paralysis, pulmonary embolism, and cement leakage.
WRONG ANSWERS:
The remaining answers are relative or absolute contraindications to vertebroplasty/kyphoplasty.
REFERENCE:
Holwerda, Ross, et al. “Vertebroplasty and Kyphoplasty.” STATdx, Elsevier, 2020.
