Figure 1: Lateral radiograph of spine showing diffuse osteopenia and compression fracture of the T12 vertebral body.

Figure 2: Sagittal T1 image of the thoracic spine demonstrating an osteoporotic compression fracture of the T12 vertebral body. Angulation through the T11-12 interspace produces a minimal impression on the anterior aspect of the thecal sac. There are no retropulsed fragments and the remainder of the study was unremarkable.

Figure 3: Frontal image demonstrates placement of the needle through the right pedicle of the affected vertebral body.

Figure 4: Lateral image demonstrates satisfactory needle position in the anterior one-third of the affected vertebral body.

Figure 5: Frontal image (DSA with 50% background) from the vertebral venogram demonstrating the perivertebral venous drainage. The angiographic series showed only indirect filling of these veins.

Figure 6: Lateral image (DSA with 50% background) from the vertebral venogram demonstrating the perivertebral venous drainage. The angiographic series showed only indirect filling of these veins.

Figure 7: Lateral image after injection of methyl methacrylate demonstrating satisfactory filling of the vertebral body in the sagittal plane.

Figure 8: Frontal image after injection of methyl methacrylate demonstrating satisfactory filling of the right side of the T12 vertebral body but little cross over to the left. In order to complete the procedure a left transpedicular puncture will be required.

Figure 9: Frontal image during methyl methacrylate injection via the left transpedicular puncture shows filling of the left side of the T12 vertebral body.

Figure 10: Post procedure frontal image showing good filling of the entire T12 vertebral body.

Figure 11: Post procedure image showing good filling of the entire T12 vertebral body. A small amount of cement has refluxed through the needle tract (arrow).