Vertebroplasty - Vertebroplasty Treatment using Minimally Invasive Surgical Solutions

Vertebroplasty is a treatment procedure developed by interventional radiologists to stabilize broken bones in the spine caused by osteoporosis. In the procedure, a needle about the size of a cocktail straw is inserted through the skin and into the crushed vertebrae. A surgical bone cement called poly-methylmethacrylate is injected into the bone to stabilize it.

cement in vertebrae after Vertebroplasty

Often, more than one crushed vertebrae can be treated in a single procedure. Surgery is not required because
the doctor is able to guide the needle to the right spot using an imaging technique called fluorscopy that makes use of special X-ray equipment. Vertebroplasty takes from one to two hours to perform depending on how many bones are treated. The procedure may be performed with a local anesthetic that numbs the area to be treated, or the patient may be given general anesthesia.

Vertebroplasty can be performed in an outpatient surgical center, although most patients have the procedure done in a hospital and stay overnight afterwards.

In vertebroplasty, a needle about the width of a cocktail straw is inserted through the skin into the fractured bone. A bone cement is injected. The cement hardens, stabilizes the bone and prevents further collapse. This stops the pain caused by bone rubbing against bone.

Some patients experience immediate pain relief after vertebroplasty. Most report that their pain is gone or significantly better within 48 hours. Many people can resume their normal daily activities immediately.

Frequently Asked Questions

Is the procedure safe?

Vertebroplasty is very safe. Although it is a relatively new treatment in the U.S., vertebroplasty has been performed for more than a decade at several centers in France with excellent results. The injection technique also has been successfully used for a number of years in the U.S. to treat other conditions in the spine. For example, it is used to treat cancer and blood vessel abnormalities. The bone cement used to
stabilize the fractured vertebrae has been shown to be safe through many years of use in joint replacement surgeries and other orthopedic procedures.

Who is a candidate for vertebroplasty?

People who have suffered recent compressing fractures that are causing them moderate to severe back pain
are the best candidates for vertebroplasty. In some cases, older fractures may be treated, but the procedure is most successful if it is performed soon after the fracture occurs. The procedure is not used to treat chronic back pain or herniated disks.

How successful is vertebroplasty?

Studies have shown that from 75 percent to 90 percent of people treated with vertebroplasty will have complete or significant reduction of their pain.

What are the risks or complications?

Vertebroplasty is a very safe procedure with few risks or complications. In many studies, no complications were reported. As with any medical procedure, the possibility of complications will depend on the individual patient. For example, patients with tumors in the spine or with other serious medical conditions may be at higher risk for complications from vertebroplasty. You should always ask your doctor to discuss risks and complications with you before you undergo any procedure.

Will vertebroplasty treat or prevent loss of height or "widow’s hump"?

After a vertebra has fractured, there is typically a loss of only 20 percent to 30 percent of the height of the bone. But over several weeks, fractures may reoccur and the vertebra flattens out, until eventually there’s a 70 percent to 90 percent loss of height in the bone. Gradually, the back hunches over and the person loses height, especially if several vertebrae are involved. Vertebroplasty cannot reverse this loss of height or kyphosis (often called "widow’s hump) in individuals who already have these conditions.

Some studies suggest that early treatment of spinal fractures with vertebroplasty can strengthen the spine and improve the posture, which may help prevent further fractures that lead to height loss or kyphosis. Currently, however, there is no evidence to prove that the procedure will prevent these problems. However, new research on the horizon is looking at ways to solve these problems.

On the Horizon

A number of new approaches to vertebroplasty are in development:

• Researchers are looking into new cements that will convert to bone and stimulate bone growth.

• "Kyphoplasty" is a procedure under investigation that involves inserting a small balloon at the point where the vertebra has collapsed. The balloon is inflated to raise the bone and then cement is injected into the space. Researchers hope the procedure will restore or prevent height loss.

• Vertebroplasty may also be used preventively in the future to treat fragile, osteoporotic vertebrae in high-risk patients before they fracture.