Vertebroplasty

What it is

Vertebroplasty is a minimally invasive outpatient procedure to treat painful vertebral compression fractures in the spinal column, which are a common result of osteoporosis or a spinal tumor. Compression fractures are breaks in the bones that make up your spine (vertebrae). When the broken pieces of bone rub together, it causes pain. Vertebroplasty is performed percutaneously by injecting PMMA bone cement to hold the bones in place to prevent them from collapsing and provide pain relief. Most patients experience significant pain relief immediately after the vertebroplasty and the average hospital stay is one day (or less). Patients can quickly return to the normal activities of daily living.

Vertebroplasty

Indications

• Painful vertebral compression fractures from osteoporosis
• Vertebral hemangioma
• Spinal metastases
• Chronic fracture from injury

In vertebroplasty, the spine surgeon will insert a needle into your skin and use a type of X-ray called fluoroscopy to guide the needle into the proper position in your bone. Through the needle, the surgeon will inject surgical cement into the affected area of the bone. The cement holds your bones together.

Vertebroplasty procedure lasts about 30 minutes. When the surgeon finishes the procedure, he/she will remove the needle and place a bandage over the puncture site. You’ll need to leave this bandage on for a couple of days as your spine surgeon recommends. You may need someone’s help to remove the bandage from your back when it’s time to take it off.

Someone will have to drive you home after your procedure. You can go home the same day and should anticipate resting for about 24 hours. Whether you will be able to discharge within 24 hours depends on your age, the severity of the problem and the support that you have at home. Avoid any heavy lifting or strenuous exercises for a few weeks following vertebroplasty.

What it is

Kyphoplasty

Kyphoplasty is a minimally invasive procedure to treat compression fractures in your spine. Compression fractures can cause the bones in your spine to collapse, leading to kyphosis or a curve in your spine that makes it look like you’re hunched over. It can limit your breathing or the function of your abdominal organs. Kyphoplasty prevents this curve from happening.

On the day of your surgery, an anesthesiologist will give you moderate sedation or anesthesia. This depends on what your surgeon needs to do. With moderate sedation, you’ll feel minimal discomfort or you’ll be asleep with general anesthesia. During the kyphoplasty procedure, you’ll lie on your stomach.

Your spine surgeon will insert a hollow needle, called a trocar, through your skin and into the affected bone in your spine. A type of X-ray, called a fluoroscopy guides the trocar into the proper position.

Once the trocar is in place, your surgeon will put an inflatable, balloon-like device into your vertebra through the trocar. As the balloon inflates, it helps regain vertebral height and opens a space for your surgeon to inject bone cement there. The cement prevents your bones from further collapsing.

Contraindications

Kyphoplasty

There are several contraindications for vertebroplasty – kyphoplasty and special attention must be paid. In particular, if the patient is experiencing blood clotting disorders, vertebral body cage subsidence, or pressure on the meningeal sac due to vertebral fracture, then he/she cannot be operated on.

Results

Vertebroplasty – Kyphoplasty

After vertebroplasty and kyphoplasty, the patient does not feel any pain and there is a vertebral height restoration. The success rates of these two procedures reach 92%. The continuous improvement of the materials and the imaging methods in combination with the doctor’s experience play an important role in the results of these procedures and minimize the complications.