The procedure known as vertebroplasty is used for stabilizing a spinal fracture and to ease the pain the fracture causes. Because it is administered by simply puncturing the patient's skin, rather than with an open incision, it is thought to be minimally invasive.
How this procedure is done
The patient is given light sedation and local anesthesia, and if he or she has difficulty in tolerating sedatives, only a local anesthetic is used. During the procedure, a biopsy needle is used to inject special bone cement into the fractured or collapsed vertebra. This is accomplished with the guidance of a fluoroscopic x-ray.
Note that the cement, which hardens quickly, creates a support structure in the vertebra, providing both strength and stabilization to the bone. Also, the tiny puncture in the patient's skin that remains only has to be covered with a bandage.
What patients can expect
This procedure is usually completed within an hour, and bed rest is generally recommended for the next 24 hours. Patients can gradually increase their normal activities, and in most cases, they can also resume taking their prescribed medications. If patients experience any soreness at the puncture site, they can use an ice pack to relieve it.
As a rule, patients are warned against driving themselves home after having the procedure. Consequently, if they have a long distance to travel, they may have to spend the night somewhere in the area before continuing their journey. If the patient is frail, requires further observation or will be unassisted at home, a brief hospital stay may also be recommended
Finding a specialist
Doctors performing vertebroplasty include radiologists, interventional neuroradiologists, neurosurgeons, orthopedic spine surgeons and pain management physicians. Certification requirements in this area include training in using the fluoroscopically guided needle, preparing the acrylic bone cement for the procedure, setting up the cement delivery system, and delivering the cement safely into the patient's vertebra. The related training also covers criteria for selecting patients who can tolerate the procedure and protocols for patient care.
Latest medical findings
At this point, it is unknown whether either this procedure or kyphoplasty will increase the patient's risk of another bone fracture. However, it has been established that a patient who sustains a fracture due to osteoporosis may also suffer additional fractures.
The procedure's effectiveness is also somewhat controversial. Two blinded and randomized trials that were conducted found no benefit for the participants, but they did not include subjects who had suffered acute vertebral fractures. It has also been stated that this procedure will only be successful when it done on patients whose injuries are six weeks old or less, and these two trials were not conducted on that basis.
How patients benefit from having the procedure
Many people who have this done experience a significant lessening of their pain within 24 to 48 hours and an improvement in their ability to perform normal daily activities as well. Recent research has also revealed that the procedure often relieves pain resulting from compression fractures for approximately three years afterwards.
Complications from having this done
While this procedure is highly successful in many cases, the complications arising from it include bleeding, infection, increased back pain, numbness and tingling. Other risks include nerve root compression, extrusion of cement into the spinal cord through the vertebral canal, blocking of an artery in the lungs by the formation of blood clots, and the usual risks associated with the use of anesthesia.