Vertebroplasty Procedure
Overview
Vertebroplasty is a minimally invasive procedure mainly used to address compression fractures in the spine. During this treatment, a type of bone cement called polymethylmethacrylate (PMMA) is injected into the affected vertebrae. The goal is to stabilize the fractured bone and ease pain.
Osteoporosis—a disease that weakens the bones, especially in older adults—is the most common cause of these fractures, but spinal tumors can also lead to them. Although some spinal fractures cause little or no discomfort, doctors suggest vertebroplasty when pain is serious or does not improve. An interventional radiologist often performs this method.
Reasons for the Procedure
Doctors mainly use vertebroplasty to help people experiencing severe pain from vertebral compression fractures. Osteoporosis, cancer, or bone diseases like multiple myeloma often cause these fractures by weakening the vertebrae.
Everyday actions such as bending, coughing, or even rolling in bed can break these weakened bones. Vertebroplasty may also help improve bone density, limit worsening kyphosis, and provide relief for those with osteonecrosis or vertebral hemangioma.
Common Causes
| Condition | Effect on Bones |
|---|---|
| Osteoporosis | Low bone density |
| Cancer (e.g., multiple myeloma) | Weakens vertebrae |
| Osteonecrosis | Destroys bone tissue |
Symptoms Treated
- Sharp, constant, or severe pain.
- Reduced movement due to a fractured vertebra.
- Spinal deformity (kyphosis).
Possible Complications and Side Effects
Vertebroplasty and similar treatments may lead to certain risks. Some of the possible complications include:
- Cement Leakage: The cement can sometimes escape from the bone. If this happens, it may press on nerves or the spinal cord, possibly leading to pain, nerve injury, or neurological problems. On rare occasions, leaked cement can travel to other organs such as the lungs, heart, kidneys, or brain, causing serious health issues.
- Bleeding: The use of a needle during the procedure brings a small chance of bleeding.
- Infection: Infections at the site where the needle enters the skin can occur, but these are typically rare.
- Additional Fractures: Bones near the treated spot may break.
- Other Complications: Fever and allergic reactions to the materials used are possible, but not common.
| Complication | Possible Effects |
|---|---|
| Cement leakage | Nerve injury, neurological symptoms |
| Bleeding | Blood loss |
| Infection | Fever, local infection |
| Allergic reaction | Rash, difficulty breathing |
| New fractures | Pain in nearby bones |
Paralysis is very rare but can occur if cement or swelling puts pressure on the spinal cord.
Steps to Get Ready
Doctors advise patients not to eat or drink for several hours before the procedure. Most daily medicines can be taken in the morning with a small sip of water, but blood thinners should typically be stopped as instructed by a healthcare provider. Patients should discuss all medications, including pain relievers and muscle relaxants, with the provider before the procedure.
Before treatment, doctors review diagnostic imaging such as x-rays, MRI, or CT scans. Patients should wear comfortable clothes, leave jewelry at home, and arrange for a ride after the procedure.
Checklist for Preparation
| Task | Details |
|---|---|
| Food & Drink | As directed by the provider. |
| Medications | Take as advised; avoid blood thinners. |
| Imaging | Ensure all X-rays and scans are completed. |
| Personal Items | Wear loose clothing and no jewelry. |
| Transportation | Arrange a ride home. |
What You Might Experience
While the Treatment Is Being Done
Patients usually change into a hospital gown and have an IV line placed in their arm or hand for medicine. The type of anesthesia varies, but most receive sedatives to help them stay comfortable and relaxed; only a few receive general anesthesia that brings deep sleep.
Patients lie face down, and the skin over the back gets numbing medicine. The health care provider uses X-ray or CT scan images to carefully move a needle into the broken vertebra. This is often a bone biopsy needle. Once the needle is in the right place, the provider gently injects acrylic bone cement or surgical cement into the spine.
The cement becomes hard in about 20 minutes and stabilizes the fracture. If cancer causes the spine fracture, doctors might remove a bone sample or give radiation before or after putting in the cement.
Key Tools Used During the Procedure
| Tool/Item | Purpose |
|---|---|
| Hospital Gown | Keeps patient clean and safe. |
| IV Line | Provides medicines or fluids. |
| X-ray/CT Scan | Guides the needle’s placement. |
| Bone Biopsy Needle | Delivers cement to the bone. |
What to Know Afterward
In most cases, people go home the same day. A family member or friend should drive them home. Some soreness or mild pain may show up at the spot on their back where the needle went in. Using an ice pack wrapped in cloth for about 15 minutes each hour helps ease discomfort.
Doctors tell patients to rest and follow all care instructions closely. Heavy lifting or bending should be avoided for at least six weeks. Sometimes, a provider might recommend back braces or more bed rest to help the healing. If any new pain or problems with movement develop, patients should follow up with the health care team.
Common Post-Procedure Reminders
- Avoid lifting anything heavy.
- Watch for changes in soreness or mobility.
- Use ice packs for pain control.
- Follow instructions on movement and rest.
Findings
Vertebroplasty has produced mixed results in pain relief and functional recovery. Clinical studies showed that some patients experienced similar pain reduction from vertebroplasty as from placebo treatments. Both procedures frequently contributed to a reduction in pain levels. Recent research suggests vertebroplasty and kyphoplasty may support pain relief for at least 12 months.
Benefits Noted
- Reduced back pain.
- Improved mobility and ability to do daily tasks.
- Some patients required less physical therapy.
| Factor | Reported Change |
|---|---|
| Pain | Relief is often reported. |
| Mobility | Improved for many. |
| Daily Activities | Easier to perform. |
| Rehabilitation | Sometimes shorter. |
Patients usually attended follow-up appointments to track their quality of life. However, since bone strength problems remain, ongoing treatment and monitoring is important.
