Table 3.

Tips suggested to prevent PMMA cement extravasations.

(1)  An optimal positioning of the fenestrated pedicle screws is crucial
(2) Screws must be placed in the middle of the pedicle to avoid cortical breaches
(3) A good preoperative CT planning is recommended to select the correct diameter of screws
(4) No injection if breaches suspected or if bicortical screw fixation
(5) Start injection of cement when the high viscosity is obtained
(6) Make injection under fluoroscopic control
(7) Prefer the used of a controlled delivery system so as the V-MAX to be able to stop immediately the injection
(8) Avoid to inject high volume of cement (we suggest 1.5 to 3 mL/screw)