Vertebroplasty

Description

Vertebroplasty is done in a hospital or outpatient clinic.

• You may have local anesthesia (awake and unable to feel pain). You will likely also receive medicine to help you relax and feel sleepy.
• You may receive general anesthesia. You will be asleep and unable to feel pain.

You lay face down on a table. The health care provider cleans the area of your back and applies medicine to numb the area. 

The doctor places a  large needle through the skin and into the spine bone. Real-time x-ray images are used to guide the doctor to the correct area in your lower back.

Cement is then injected into the space to make sure it does not collapse again.

This procedure is similar to kyphoplasty, but it does not use a balloon to restore the spinal bone's height.

Why the Procedure is Performed

 A common cause of compression fractures of the spine is thinning of your bones, or osteoporosis. Your doctor may recommend this procedure if you have severe and disabling pain for 2 months or more that does not get better with bed rest, pain medicines, and physical therapy. 

Your doctor may also recommend this procedure if you have a painful compression fractures of the spine due to

• Cancer, including multiple myeloma
• Injury that caused broken bones in the spine

Risks

Kyphoplasty is generally safe. Complications may include:

• Bleeding
• Infection
• Allergic reactions to medicines
• Breathing or heart problems if you have general anesthesia
• Leakage of the bone cement into surrounding area (this can cause pain if it affects the spine or nerves) - this problem is more common with this procedure than kyphoplasty

Before the Procedure

Always tell your doctor or nurse:

• If you could be pregnant
• What drugs you are taking, those you bought without a prescription
• If you have been drinking a lot of alcohol

During the days before the surgery:

• You may be asked to stop taking aspirin, ibuprofen, coumadin (warfarin), and any other drugs that make it hard for your blood to clot several days before.
• Ask your doctor which drugs you should still take on the day of the surgery.
• If you smoke, try to stop.

On the day of the surgery:

• You will usually be told not to drink or eat a anything for several hours before the test.
• Take your drugs your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive.

After the Procedure

You will probably go home on the same day of surgery. You should not drive, unless your doctor says it is OK.

 After the procedure:

•  You should be able to walk. However, it's best to stay in bed for the first 24 hours, expect to use the bathroom.
• After 24 hours, slowly return to your regular activities.
• Avoid heavy lifting and strenuous activities for at least 6 weeks. 
• Apply ice to the wound area if you have pain where the needle was inserted.

Outlook (Prognosis)

Patients who have this procedure usually have less pain and a better quality of life after the surgery.

They usually need fewer pain medicines, and can move better than before.

References

Esses SI, McGuire R, Jenkins J, et al. The treatment of symptomatic osteoporotic spinal compression fractures. J Am Acad Orthop Surg. 2011 Mar;19(3):176-82. 

Anselmetti GC, Muto M, Guglielmi G, et al. Percutaneous vertebroplasty or kyphoplasty. Radiol Clin North Am. 2010 May;48(3):641-9.

Update Date: 12/1/2011

Updated by: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery.