Vertebroplasty is a minimally invasive procedure performed to treat vertebral compression fractures (VCF).

Vertebroplasty is a minimally invasive procedure performed to treat vertebral compression fractures (VCF). These fractures, which can be painful and limit spine mobility, are commonly caused by osteoporosis, spinal tumors, and traumatic injury. Traditional treatments of bed rest, pain medication, and braces are slow to relieve the pain. In patients who have continued severe pain despite non-operative measures, or in those with a fracture that is collapsing despite brace usage, Vertebroplasty may be an option. Small incisions are made in the back and tiny balloons are then introduced into the fractured bone under Xray guidance. “Bone cement” is then injected into the void. By injecting bone cement into the fractured bone and restoring the vertebra height, this procedure offers patients opportunity for a faster recovery and reduces the risk of future fractures in the treated bone. There is also greater stability created and hence a smaller possibility for the fracture to collapse.

You may be scheduled for pre-surgical tests, including a blood test, electrocardiogram or chest X-ray several days before surgery. In the doctor’s office you will fill out paperwork and sign consent forms so that Dr. Kube knows your medical history like allergies, anesthesia reactions and previous surgeries. You should stop taking all non-steroidal anti-inflammatory medicines (Naproxen, Advil, Motrin, Aleve, etc.) and aspirin one week before your surgery.

Patients are admitted to the hospital the morning of the procedure. No food or drink is permitted past midnight the night before surgery. An intravenous (IV) line is placed in your arm. To minimize pain and discomfort, you will be given either general anesthesia, which puts you to sleep, or conscious sedation. Under conscious sedation you are awake, but feel no pain and may have no memory of the procedure.

Once sedated, you will be positioned on your stomach with your chest and sides supported by pillows. Depending on the section of the spine (cervical, thoracic, or lumbar) where the compressed vertebra is located, your back or neck will be cleansed and prepped. A local anesthetic is injected in the area where a small, quarter inch skin incision will be made over the fractured bone. With the aid of a fluoroscope (a special X-ray machine), one or two large diameter needles are inserted into the vertebral body through the pedicles. The fluoroscopy monitor allows the surgeon to see exactly where the needles are positioned and how far they are inserted. The needles are angled to avoid the spinal cord. Depending on the vertebral level, a single needle may be used. Patient positioning on the OR table helps to reduce the fracture as does the injected cement. The amount of height restored depends on the age of the fracture. Bone cement is slowly injected under pressure, filling the deepest area first, and then withdrawing the needle slightly to fill top areas. The pressure and amount of cement injected are closely monitored to avoid leakage into unwanted areas. While complete filling of the vertebral body is ideal, it is not always possible or necessary for pain relief. The needles are withdrawn promptly before the cement hardens. The small skin incision is closed with suture and steri-strips. You will not be moved from the operating table until the remaining cement in the mixing bowl hardens.

You will return to the recovery area. Your blood pressure, heart rate, and respiration will be monitored and your pain will be addressed. You’ll remain lying down for some time after the procedure. Most patients are sent home on the day of the operation. Occasionally a patient may need to stay in the hospital overnight for observation and then released the next morning.

A majority of patients have a substantial improvement in the level of pain they are experiencing. There is also stability created in the treated fracture. It is important to note that like all procedures, the success rates are not 100% and some patients continue to have pain despite treatment. It is also important to note that since many of these fractures are a result of osteoporosis and bone quality issues, around 20% of patients will be diagnosed with an additional fracture within a year.

Therefore, if pain recurs, it is important to be seen by your surgeon as soon as possible to verify that another fracture has not occurred.