This thesis focuses on indications for and the clinical outcome of PVP for the treatment of long-standing OVCFs (i.e. after more than 8 weeks after onset of symptoms). Secondly, emphasis is made on... Show moreThis thesis focuses on indications for and the clinical outcome of PVP for the treatment of long-standing OVCFs (i.e. after more than 8 weeks after onset of symptoms). Secondly, emphasis is made on the value of vertebral body biopsy during the vertebroplasty procedure in order to aid in early diagnosis of unexpected conditions. Thirdly, in line with the worldwide emerging registration and control of medical implants, emphasis is put on the need for careful registration of cement leakages, since these count for the largest number of clinically relevant complications of the vertebroplasty procedure. The correlation between the amount of BME and the clinical outcome (pain) of PVP is discussed in Chapter 2. In Chapter 3, the outcome of a routine bone biopsy during PVP in treatment of __osteoporotic__ vertebral fractures, was studied. A prospective follow-up study on the clinical outcome (Quality of Life as measured with the SF 36) up to 36 months after PVP for long-standing OVCFs, is discussed in Chapter 4. In Chapter 5, the clinical outcome of PVP in patients with long-standing OVCFs, treated with either low or medium viscosity PMMA bone cement, was evaluated in a prospective comparative follow-up study. In Chapter 6, a new system for Evaluation and registration of eXtra vertebral cement leakage based on Anatomy and Volume of the leakage using CT-scan analysis (the EXACT classification system), is proposed. Finally, in Chapter 7 a review of the scientific evidence for PVP is presented. Show less