Which anatomy is relevant to percutaneous vertebroplasty (PVP)?

Updated: Nov 12, 2019
  • Author: Gaurav Gupta, MD; Chief Editor: Justin A Siegal, MD  more...
  • Print


A normal thoracic spine is immobile and consists of 12 vertebrae. There are important anatomic landmarks to consider including a body, pedicles, laminae, spinous processes, and facet joints. Importantly, thoracic vertebrae have prominent lateral processes that form the articulation with the paired 12 ribs on either side. The 12 vertebrae, 24 ribs, and sternum together form the chest cavity, allowing negative-pressure respiration and providing protection of the chest wall. 

Illustration of thoracic vertebrae showing vertebr Illustration of thoracic vertebrae showing vertebral body, pedicles, facets, transverse process, rib joints, spinous process, and lamina.

The lumbar spine is the next segment of the spine and is more mobile than the thoracic. The lumbar spine typically consists of 5 large vertebrae and important landmarks, including the body, pedicles, lamina, spinous processes, facet joints, and lateral processes. The lumbar spine is mobile with all articulations, contributing to flexion-extension, bending, and rotation allowing for truncal mobility.

Lumbar vertebrae are characterized by massive bodi Lumbar vertebrae are characterized by massive bodies and robust spinous and transverse processes. Their articular facets are oriented somewhat parasagittally, which is thought to contribute the large range of anteroposterior bending possible between lumbar vertebrae. Lumbar vertebrae also contain small mammillary and accessory processes on their bodies. These bony protuberances are sites of attachment of deep lumbosacral muscles.

This anatomy is important to consider in three-dimensional space and be easily identifiable on X-rays in order to facilitate optimal placement of the needle under fluoroscopic guidance. An important step in understanding these procedures is to have a grasp of radiographic anatomy. (See Technique.)

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!