Vertebroplasty

Vertebroplasty is a medical procedure that is employed to treat compression fractures in the vertebrae. The procedure involves injecting medical grade bone cement into the vertebral bones that have been damaged or collapsed. This procedure offers support. Osteoporosis is the most common cause for fractured spine bones. Spinal tumors, traumatic injuries and rarely Hemangioma are some of the other causes for vertebral compression fractures (VCF) of the spine. However osteoporosis-led vertebral fracture is the most common clinical situation in which vertebroplasty is used. These fractures cause severe pain and reduce the mobility of the patient. Vertebroplasty is a recently developed image-guided surgical procedure with minimum invasion that promises faster pain relief. Vertebroplasty becomes the best alternative choice when conservative pain management does not provide relief to the patient. It is a simple day-care procedure that not only helps in stabilizing the broken bone but also prevents further compression of the affected vertebral area.

Vertebroplasty Procedure

An MRI scan is performed on the patient prior to the procedure to confirm the fracture. If MRI scan is not recommended for the patient due to any specific medical condition, CT scan is carried out to assess the exact location of the fracture. If the patient is on any kind of medication, it should be informed to the doctor. Anticoagulation medicines or blood thinners have to be stopped at least five days before the surgery. Vertebroplasty is performed under local anesthesia with sedation by an Interventional radiologist or neuroradiologist. He should be well trained in fluoroscopically guided needle placement and should be able to deliver the cement to the exact position skillfully.

The patient is made to lie face down during the procedure. A small hollow point needle is positioned into the crushed bone. The doctor navigates the needle into position using a . Once the needle is in position, bone cement is directly injected into the collapsed bone to secure it. It is a special cement called polymethylmethacrylate (PMMA) that hardens within 10 to 20 minutes and restores the strength and shape of the vertebrae alleviating the pain caused due to compression. Though PMMA cement is the most widely used ingredient to repair vertebral fractures, other new substances such as cortoss (an injectable, non-resorbable, polymer composite that is designed to mimic cortical bone) are being explored in place of PMMA cement as excess polymethylmethacrylate cement can become toxic in the body. More than one fracture can be fixed at the same sitting. Vertebroplasty reduces the pain instantly and helps the patient to return to normal activity in a short period of time. Few hours of rest is recommended soon after the procedure; however the patient can be discharged the same day.

Vertebroplasty is generally a safe procedure. But in rare cases, the cement may leak into adjacent areas leading to complications. If the leaked cement enters the vein and travels to the lungs, it will cause serious pulmonary problems. In worst cases, cement leak may press upon the spinal cord or compress nerves leading to nerve damage. It may also require further surgery to treat the condition. Possibility of infection, allergy and bleeding are some of the other risks associated with Vertebroplasty. Vertebroplasty is not a recommended treatment for herniated disks or arthritis related back pain.

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