Vertebroplasty is a minimally invasive spinal surgical procedure to treat vertebral compression fractures caused by weakened bones. Vertebral compression fractures occur when bones in the spine break which happens due to trauma, such as a car accident or fall, but are most commonly the result of osteoporosis which causes weakened bones. Compression fractures can also be caused by other bones weakening conditions such as certain cancers or long term steroid use.
The spine, also called the back bone, is designed to give us stability, smooth movement, as well as providing a corridor of protection for the delicate spinal cord. It is made up of bony segments called vertebrae and fibrous tissue called intervertebral discs.
Compression fractures can lead to progressive spinal deformity. When multiple fractures occur, a condition known as Kyphosis, or dowager’s hump, causes the back to become rounded and bent forward which can affect quality of life making it more difficult to breathe, eat, walk, or sleep.
Vertebroplasty is an elective surgery to treat painful compression fractures of the spine that have not responded to conservative treatment options such as rest, medication, or back bracing The ultimate goal of a Vertebroplasty surgery is to:
- Alleviate or reduce the patient’s pain
- Restore the fractured vertebra to its pre-fracture height
- Improve spine functionality
- Restore normal alignment of the spine
Evaluating the source of back pain is critical in determining your options for pain relief and the location of where to perform surgery. Your doctor will take your medical history and perform a physical examination. Diagnostic Studies to confirm a vertebral fracture and its cause may include:
- X-rays: A form of electromagnetic radiation that is used to take pictures of bones.
- MRI: Magnetic and radio waves are used to create a computer image of soft tissue such as nerves and ligaments.
- CT Scan: This test creates 3D images from multiple x-rays and shows your physician spinal structures not seen on regular x-ray.
- Bone Density Test: A test used to diagnose osteoporosis using special x-rays to determine bone density or strength.
A Vertebroplasty surgical procedure is performed to stabilize a spinal fracture, thus stopping the pain caused by the fracture itself. he surgery is performed under sterile conditions in the operating room with the patient under general or local anesthesia and lying face down on the operating table.
- Your doctor will make a very small puncture in the skin over the fracture site. This procedure does not require incisions.
- Under live X-ray guidance, a hollow needle is introduced through the back where it is positioned within the fractured vertebrae.
- Medical grade bone cement is then injected into the area through the needle.
- X-rays or CT scans may be done to confirm effective distribution of the bone cement.
- The needle is then withdrawn, pressure is applied, and a sterile bandage is placed.
Vertebroplasty Postoperative Care
Many patients feel immediate pain relief following a vertebroplasty procedure. For others, it may take a few days or weeks before showing improvement. Most patients are discharged home the very same day of the surgery. Please follow the below recommendations after your surgery.
- You should rest in bed for the first 24 hours but can get up to use the bathroom.
- Pain medication will be given to make you comfortable for the first few days.
- Ice packs placed over a cloth can be applied to the surgical area for 20 minutes every hour.
- You will be restricted from heavy lifting or strenuous activities for the first 6 weeks.
- A postoperative rehabilitation program may be prescribed by your doctor to strengthen spinal muscles two weeks after your surgery.
Even though vertebroplasty is a minimally invasive surgery, there are potential risks involved as with any major surgery. At the end of the day, the decision always belong the patient and if a patient decided to proceed, it is because the potential benefits of the surgery outweigh the potential risks. The Complications associated with any surgery can be medical (general) or specific to spinal surgery. Some specific complications of Vertebroplasty surgery include:
- Nerve damage or spinal cord injury from leaking cement
- Deep or superficial wound infection
- Increased back pain
- Numbness and tingling