Vertebroplasty is a medical procedure that is used to stabilize the vertebrae following a spinal fracture. If you've been consulted to get one, here's what you'll want to know about the spinal procedure. 

What is a vertebroplasty?

The vertebroplasty operation involves the injection of cement into fractured or broken vertebrae to increase stability and support of the spine.

It is a similar procedure to kyphoplasty–both are minimally-invasive ways to treat spinal compression caused by fractures and breakages in the vertebrae.

What is the difference between vertebroplasty and kyphoplasty procedurs?

Both vertebroplasty and kyphoplasty are used to treat problems with the spine. They both use a small, hollow needle that gets fed through the fractured vertebrae of the spine [1].

Despite being similar procedures, vertebroplasty and kyphoplasty have distinct differences.

Vertebroplasty involves injecting special bone cement (polymethylmethacrylate) through the hollow needle into each of the fractured vertebrae. The bone cement can strengthen the vertebrae so that a recurrent fracture is less likely.

Kyphoplasty, on the other hand, uses special balloons that create spaces in the fractured vertebrae. These spaces are then filled with cement. This procedure is often used to correct deformities in the spine and to restore height.

Who is a suitable candidate for vertebroplasty?

Those who have experienced a vertebral compression fracture, or VCF for short, may be offered vertebroplasty. In VCFs, the vertebrae collapse onto one another, forming a wedge shape. This can be extremely painful and causes a condition known as kyphosis.

People who suffer from osteoporosis, a condition where the bones become weak and brittle, are more likely to have fractures and breakages. This includes fractures in the vertebrae of the spine. They are, therefore, more likely to require vertebroplasty at some point in their lives [2].

Individuals with cancer of the bone marrow, medically known as multiple myeloma, are also more susceptible to compression fractures.

You can suffer from a compression fracture in your spine without having a pre-existing condition. Vertebral compression fractures can occur from something as simple as sneezing, coughing, or lifting heavy objects with poor form. They may also occur due to trauma or injury of the spine.

Although vertebral compression fractures can heal on their own, they will do so in a wedged position if a vertebroplasty procedure is not performed. The vertebroplasty will reposition the collapsed vertebrae to ensure it heals in the right place.

If you fit into any of the following criteria, you may not be an ideal candidate for vertebroplasty:

• If you have osteomyelitis (an infection in your bones)
• If you suffer from a bleeding disorder
• If you have a fracture fragment or tumor in your spinal cord

Who performs vertebroplasty procedures?

Vertebroplasty procedures are performed by a qualified medical professional. More specifically, vertebroplasty are performed by neurosurgeons or orthopedic surgeons. There will be a number of other medical staff in the room during the procedure, including a neuroradiologist, an anesthesiologist, and several theatre staff.

What happens during a vertebroplasty procedure?

Your doctor will first evaluate your current condition. They will do so by taking your bloods and using diagnostic imaging techniques, including x-rays, computer tomography (CT), and ultrasound scanning.

They will also gather your medical history and ask about which medications you are currently taking. This is important as certain health conditions and medications can affect the efficacy and safety of the vertebroplasty procedure.

If you are on blood-thinning medications, such as warfarin, you will likely be asked to stop taking your tablets a week or two before your date of surgery. You may also be asked to refrain from eating or drinking for 12-24 hours before the procedure.

The procedure takes around one hour per vertebra. You will be asked to lie on a table and your doctor will administer a local anesthetic. You will be positioned on your stomach and the area of your spine that has the compression fracture will be cleaned and prepared.

Using fluoroscopy (x-ray) scanning to guide them, your doctor will insert a hollow needle, called a "trocar", into the body of the compressed vertebra using a careful twisting motion.

Bone cement is then injected under pressure into the vertebra. Your doctor will use imaging to monitor exactly where the cement is going to avoid any leakages.

Once the vertebra is filled in with the bone cement, the needle is quickly moved before the cement hardens. The small incision that has been made by the needle in the skin is closed using skin glue.

Post-surgery, you will be taken to a ward or recovery area where healthcare professionals can closely monitor you. If everything looks fine after 2-3 hours, you may be able to go home. Some hospitals may insist that you stay in hospital overnight just to be sure that everything is okay.

Can a vertebroplasty be performed on older fractures?

Vertebroplasty is not suitable for old fractures or chronic fractures. They are not suitable for the treatment of chronic back pain or poor posture. Other interventions are required to treat these problems.

Prior to offering vertebroplasty, doctors will usually advise other treatment methods to see if there are any improvements. If after 6-8 weeks, there have been no significant improvements, vertebroplasty will be discussed.

What are the benefits and risks of getting a vertebroplasty?

The benefits of vertebroplasty include:

• Improved physical movement and functional abilities post-procedure
• Three-quarters of patients regain lost mobility and are more active post-procedure [3]
• Quick recovery time and no need for a long hospital stay
• No large surgical incision is required
• Many patients are symptom-free after the procedure
• The procedure is relatively safe

The potential risks of vertebroplasty are:

• Small risk of infection due to the small skin incision that is required
• Small risk of the patient having an allergic reaction to the medications used during the procedure
• Risk of the bone cement leaking out of the vertebral body
• Risk of blood loss or nerve root irritation [4]
• Around 10% of patients may develop future compression fractures after the procedure

Have any questions about the vertebroplasty procedure, or would like to schedule a consultation with a radiologist in Southern California?

Contact us today!

References

[1] https://www.spine-health.com/treatment/back-surgery/vertebroplasty-and-kyphoplasty-comparisons

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3773069/

[3] https://www.radiologyinfo.org/en/info/vertebro

[4] https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/vertebroplasty