Vertebroplasty: Minimally Invasive Treatment of Vertebral Compression Fracture
Vertebroplasty is a minimally invasive and image-guided treatment for vertebral compression fracture. Vertebroplasty repairs the fracture, stabilizes the spine, and helps reduce fracture-related pain.
This procedure is termed minimally invasive because, in most cases, the patient does not need general anesthesia and incision(s) are tiny. The entire procedure is performed using real time x-ray called fluoroscopy. This advanced imaging technique enables the surgeon to view the patient’s spinal anatomy during every step of the procedure.
Advantages include:
- General anesthesia can often be avoided
- Same day procedure; seldom is hospitalization necessary
- Marked pain relief or improvement
- Need for pain medication reduced (or eliminated)
- Incisions are cosmetically appealing
- Quality of life is quickly improved
Is vertebroplasty right for you?
Only you and your doctor can make that decision. Your doctor may recommend one to two weeks of nonsurgical treatment (i.e. brace, medication) prior to vertebroplasty.
In general, vertebroplasty is indicated for patients with painful osteoporosis-related vertebral compression fractures in the cervical (neck), thoracic (mid-back), and lumbar spine (low back). Vertebroplasty may also be performed to strengthen a vertebral body prior to more extensive surgery to stabilize the spine.
Vertebroplasty is not performed:
- To treat a healed vertebral fracture
- Prevent an osteoporosis-related vertebral fracture
- Correct abnormal curvature of the spine
- To treat herniated discs or osteoarthritis-related back pain
What are the risks?
Any medical treatment, whether nonsurgical or operative, has risks. However, complications related to vertebroplasty are rare. Your doctor will discuss the following risks and others that may be personal to you.
- Problem with anesthesia
- Infection
- Cement leakage
- Pain is not relieved
Vertebroplasty Procedure
After conscious sedation, you are positioned face down on the procedure table. The procedure involves making one or two tiny incisions per fracture treated. The surgeon uses fluoroscopy to accurately guide and position each needle within the vertebra. Bone cement is injected into the fracture to fill in spaces and stabilize the vertebral body. The cement flow is monitored under fluoroscopic view.
After the proper amount of bone cement is injected, the needles are removed and each needle / incision is covered by a small bandage. Treating a single fracture takes about 30-minutes to one-hour.
After Vertebroplasty
Right after your procedure, you will spend time in the recovery room. You are discharged home when your surgeon and attending medical staff feel you are ready.
Many patients experience partial or complete pain relief during the first 24 to 72 hours. Although pain relief may be significant, you are given instructions to restrict activities for a week, or until the surgeon clears you for moderate activity. Few patients need to wear a brace after vertebroplasty because the bone cement quickly hardens and stabilizes the spine. Complete healing may take up to three months. The surgeon will monitor your progress in this area.
Your surgeon, or referring doctor, will work with you to prevent a future fracture. The treatment plan may include calcium, vitamin D, osteoporosis medication, and lifestyle modification.
Sources
Predey TA, Sewall LE, Smith SJ. Percutaneous Vertebroplasty: New Treatment for Vertebral Compression Fractures. American Family Physician. August 15, 2002. Accessed February 17, 2008. http://www.aafp.org/afp/20020815/611.html
Grainger RG, Allison DJ. Grainger & Allison’s Diagnostic Radiology, A Textbook of Medical Imaging. 5th Ed. Elsevier Churchill Livingstone, Philadelphia, PA. 2008.
Heran MKS, Legiehn GM, Munk PL. Current Concepts and Techniques in Percutaneous Vertebroplasty. Orthopedic Clinics of North America. Vol. 37; Issue 3, July 2006.
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