Overview
The procedure is performed while the patient is awake but sedated, and lying facedown so the physician has access to the back. The back is numbed by a local anesthetic. At Mayo Clinic, the procedure is performed by an interventional spine neuroradiologist — a physician with special expertise in the nerves, brain and spinal cord.
Through a small incision and guided by a fluoroscope, the neuroradiologist passes a hollow needle through the spinal muscles and into the fractured vertebra. X-ray cameras above, below and on the sides of the table provide guidance for needle placement. When the needle is in the correct position, bone cement is injected through the needle into the vertebra. As a rule, the procedure takes one hour for each vertebra that is treated.
After the procedure, patients lie flat on their backs for two hours while the cement hardens. They are then discharged and can resume normal activity. The majority of patients have significant pain relief within a few days.
Advantages of Vertebroplasty
Vertebroplasty is considered for patients with painful compression fractures in the spine, often caused by osteoporosis. Because the treatment often results in a dramatic decrease in pain, the advantages are numerous.
Decreased pain : -
A compression fracture causes sharp and debilitating pain. Those suffering from these fractures are often prescribed bed rest and pain medication. Vertebroplasty reduces and in some cases eliminates the need for pain medication, and it also restores mobility in many patients.
Increased functional abilities : -
The pain from a compression fracture is usually sharp and debilitating, leaving people unable to perform everyday tasks. 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.
Anatomy
section of each spine vertebra is a large, round block of bone called a vertebral body. Compression fractures cause this section of bone to collapse. The collapsed vertebra gives the spine a hunched appearance, called kyphosis, and the loss of vertebral height shortens the muscles on each side of the spine. This forces the back muscles to work harder, causing muscle fatigue and pain. The vertebral body is the main structure treated in the vertebroplasty procedure.
Complications
What might go wrong ?
Serious complications from vertebroplasty are rare, involving less than five percent of cases. As with other procedures, however, complications can occur.
Some of the most common complications of vertebroplasty include:
- Problems with anesthesia
- Thrombophlebitis
- Infection
- Cement leakage
- Ongoing pain
This is not intended to be a complete list of possible complications.
Surgical Procedure
What Happens During The Procedure?
The patient lies on his or her stomach. To begin, the surgeon cleans the skin on the back with an antiseptic. Then the skin and muscles over the problem area are numbed using an anesthetic. Patients may also receive general anesthesia to put them to sleep during the procedure. A small incision is made in the skin on each side of the spinal column. A long needle is inserted through each opening. The surgeon slides the needles through the back of the spinal column into the fractured vertebral body.
A fluoroscope is used to guide the needles. This is a special X-ray television camera adjusted above the patient's back that lets the surgeon see the patient's spine on a screen. Metal objects show up clearly on X-rays. The needles are easy for the surgeon to see on the fluoroscope screen. This helps the surgeon confirm that the needles reach the correct spot.
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