Vertebroplasty


What is Percutaneous Vertebroplasty?

Percutaneous vertebroplasty is a newer non-surgical technique in which medical grade cement is injected though a needle into a painful fractured vertebral body. This stabilizes the fracture, allowing most patients to discontinue or significantly decrease analgesics and resume normal activity. Patients who are unresponsive to conservative therapy of bed rest, analgesics, and back bracing should be considered for vertebroplasty.

About more than 5 crores people in the India have osteoporosis (a decrease in the amount of bone mass) or have thinning of the bones that puts them at risk for spine fractures (broken bones). Thinning of the bones can occur at any time, but is most common in elderly persons. “Compression” fractures are caused when the weakened bone of the spine collapses. This usually causes severe back pain. When several of the bones collapse, loss of height or stooped posture may occur. Usually, the fracture gets better by itself and the pain finally goes away. In many patients, however, the pain continues because the crushed bone continues to move and break.


How are spinal fractures diagnosed?

The diagnosis of vertebral compression fractures is usually need X-Ray, history, physical examination & MRI or CT scanning to determine if there is significant spinal canal compromise and to exclude other causes of back pain.

 

Indication for vertebroplasty

• Your pain is severe and the result of a compression fracture
• Other, more conservative treatments haven’t relieved your pain
• Your compression fracture is recently diagnosed and imaging tests (X-rays, MRI and bone scan) can pinpoint the location and age of the compression fracture
• Your bones are not so weakened (porous) that your ribs might break as a result of lying facedown during the procedure

Most people can be treated as outpatients and return home the same day. During vertebroplasty you are awake but sedated, and lie on your stomach. Your back is numbed by a local anesthetic and a small incision is made. Guided by X-ray cameras, your doctor injects bone cement into the damaged vertebra with a needle. Vertebroplasty usually takes one hour for each vertebra that is treated. You will need to lie flat on your back for two hours afterward while the cement hardens.


By percutaneous vertebroplasty other spine problem can be treated?

Percutaneous vertebroplasty is also useful in painful or unstable benign and malignant vertebral lesions that fail to respond to the traditional conservative therapies like multiple myeloma, haemangioma and various spinal bone cancer.


What is the recovery like? And is the procedure safe?

Many patients feel pain relief right away after vertebroplasty. Most report that their pain is gone or is much better within 48 hours. Most patients resume normal activity within 24 hours.
Vertebroplasty is very safe. The bone cement used to secure the broken bone is safe. Patients with tumors on the spine may be at slightly risk of complications. You should always discuss the risks of any procedure with your doctor.


How do I know if vertebroplasty is right for me?

If you have significant back pain caused by a broken bone (osteoporotic fractured vertebra) in your back that is not better after one to two weeks of bed rest and pain control medicine, you may need vertebroplasty. Newer fractures tend to respond better than older fractures; however, some older fractures can be treated successfully.


How successful is vertebroplasty?

The success rate for this procedure in treating osteoporotic fractures is about 90-95%. Vertebroplasty can effectively treat aggressive hemangiomas of the vertebral body and may be palliative in patients with malignant pathologic fractures.


Vertebroplasty need any hospitalization?

It can be done on day care or one night hospitalization.


What are the advantages of vertebroplasty?

Decreased pain. Vertebroplasty reduces and in some cases eliminates the need for pain medication, and it also restores mobility in many patients.
Increased functional abilities. Vertebroplasty stabilizes the fracture, decreases pain dramatically and allows a return to the previous level of activity.
Prevention of further vertebral collapse. The cement fills spaces in bones made porous by osteoporosis, strengthening the bone so that it is less likely to fracture again.