AIM: The modern spinal surgery accepts the percutaneous vertebroplasty (PV) with polymethylmethacrylate (PMMA) as a routine procedure for treatment of painful osteoporotic, neoplastic and traumatic compression fractures in the thoracic and lumbar region of the spinal column. Although considered to be a minimally invasive and safe procedure, it could be affected by severe disabling and even life-threatening complications. The aim of the present study is to evaluate the different potential

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... ations with their clinical presentation, diagnostics and different treatment options. MATERIALS AND METHODS: The study analyzed a cohort of 56 consecutive patients (66 levels) treated with PV in our clinic for the period January, 2008 -July, 2012. Of them, 31 (55.4%) were women and 25 (44.6%) -men at a mean age of 61.7 (23 -80) years. The osteoporotic and traumatic compression fractures subgroup was comprised of 44 (78.6%) patients, while the patients with neoplastic fractures were 12 (21.4%). All the fractures were classified as A1 Magerl's fractures with no neurologic deficit. RESULTS: Complications and unwanted events were registered in 9 (16.1%) patients. Of them, 2 experienced transient increased pain syndrome intensity, one of the patients presented with index level radiculopathy, 2 patients were diagnosed with extravertebral leakage of the cement in the spinal canal with compression of the neural structures and subsequently operated, 1 patient had a cement leak in the adjacent disk, 2 patients -a cement leak in the paravertebral soft tissues and the paravertebral venous system, and one had cement pulmonary embolism. CONCLUSION: PV is a minimally invasive and effective procedure that is used in the treatment of painful osteoporotic, traumatic and neoplastic compression fractures on neurologically intact patients. The clinically significant complications and unwanted events are a relatively rare encounter and in the majority of the cases are treatable with conservative measures. The epidural cement migration with neural elements compression is the only indication for surgical decompression and removal of the compressing cement.