What should be avoided when injecting PMMA into the vertebral body during vertebroplasty?

When performing vertebroplasty, one of the critical considerations is to minimize the risk of complications associated with the injection process. Avoiding leaking of polymethylmethacrylate (PMMA) into adjacent tissue is vital because such leakage can result in serious complications, including nerve damage, or can cause embolization. If PMMA escapes the intended vertebral body space, it may inadvertently flow into nearby structures, potentially leading to significant morbidity.

Additionally, rapid injection of PMMA can increase the likelihood of leakage as well. A controlled and steady injection is crucial to allow adequate filling of the vertebral body without exceeding its capacity. Proper technique is essential to maintain the substance in the vertebral body where it is intended to provide structural support.

While the other options present legitimate concerns during the procedure, the primary focus is on preventing any leakage into adjacent tissues, which can have immediate and far-reaching consequences for patient safety.