What is Vertebroplasty?
Vertebroplasty is a minimally invasive surgical procedure indicated for the treatment of vertebral compression fractures. The main aim of this outpatient procedure is to provide relief from severe pain, improve mobility and stabilize the fractures. Vertebroplasty involves injection of bone cement into the fractured vertebrae to the support the spine from further collapse. It is similar to kyphoplasty, however kyphoplasty uses balloons to create empty space within the vertebrae followed by injection of bone cement, in order to restore vertebral height.
Indications
The following conditions may be indicated for treatment with Vertebroplasty:
- Painful acute and subacute vertebral compression fractures.
- Osteoporotic vertebral compression fractures.
- Severe, disabling pain caused by compression fractures.
- Vertebral compression fractures caused by metastatic diseases, painful haemangiomas, multiple myeloma etc.
- Chronic, persistent back pain due to vertebral compression fractures
- Patients who fail to respond to conservative line of treatment for vertical compression fractures
Patient preparation
Patients suffering with constant, severe back pain are referred for appropriate evaluation including thorough medical history, physical examination and diagnostic scans such as X-rays, MRI, bone scans etc. These tests are done to determine if the patient is a potential candidate for vertebroplasty.
Once the doctor has confirmed the patient as a candidate for vertebroplasty, they are given certain instructions to be followed before the procedure. The patient is advised to avoid eating food or drinking water at least 6 hours before the surgery. Small amount of water is allowed up to 2 hours before the procedure. In some cases, certain medications may be discontinued temporarily or doses may be adjusted based on the patient’s specific health condition.
Procedure
The patient is made to lie down with the face towards a padded operating table. The surgeon may induce conscious sedation and local anaesthesia for this procedure. This will ensure that the patient does not experience pain in the area of the procedure. The needle entry area is carefully sterilized followed by a small skin incision on the back.
Then, a biopsy needle is carefully inserted into the fractured vertebrae through the incision, using fluoroscopic guidance with real time X-ray images on a monitor. Once the needle has reached the target area, bone cement is directly injected into the fractured vertebrae. The needle is remove and the cement quickly hardens to form an internal cast, stabilizing the vertebrae. Finally, the incision is covered with a bandage and the patient is kept under observation for a few hours.
Post-operative patient care
Patients are advised not to indulge in strenuous physical activities for about 6 weeks after the surgery. Most patients are discharged on the same day of the procedure, however if further observation is required they may be kept in the hospital for one day. Patients may experience mild soreness in the area of incision, however it subsides within a few days.
Recovery
Most patients may experience pain relief with the first two days of the surgery, in some cases it may take up to 3 days. Bed rest may be advised for the first 24 hours, after which the levels of activities may gradually be increased. The doctor schedules a follow-up appointment few weeks after the surgery assess pain relief and the recovery process.
Advantages
The following advantages are observed in patients treated with vertebroplasty:
- Increased functional ability.
- Successful alleviation of pain.
- Restoration of mobility in 75% of patients.
- Reduction of pain medications.
- Improved quality of life.
- Minimally invasive.
- Quick recovery
