Vertebroplasty

Performed by Top Pain Management Doctors in Fort Smith, Arkansas

Vertebroplasty, or vertebral augmentation, is a minimally invasive, out-patient procedure that alleviates chronic back pain caused by vertebral (spinal bones) compression fractures.

This treatment option is particularly helpful when conservative therapies have failed to relieve pain (De Negri 2007).

Vertebroplasty

A vertebral compression fracture occurs when the vertebrae develop small cracks, break, or collapse/compress, compromising the spine and other nearby structures in the body.

 

Other Conditions commonly treated with Vertebroplasty include:

  • Osteoporosis
  • Bone cancer metastasis
  • Injury or Trauma

Procedure

Once the area is sterilized, a local anesthesia, and possibly a sedative, are administered, the physician makes a small incision in the patient’s back. A. narrow and hollow tube is inserted into the vertebra to withdraw any dead or damaged tissues.

Image devices, such as fluoroscopy or X-ray, are used to guide the physician, so that correct needle and bone cement placement are confirmed. Medical bone cement is injected from the needle through the hollow tube to sure up the fractures. They are inserted directly into the damaged vertebral body. The bone cement quickly dries, forming a support structure within the vertebra. This provides improved spinal stabilization and strength.

Benefits

Vertebroplasty is a widely-accepted procedure that has provided great pain relief for many patients. Additionally, it increases vertebral body height, and decreases wedge angle (improper shape) without worsening of the retropulsion (backward movement) of the vertebrae (Hiwatashi 2007).

Many Patients with compression fractures often have kyphosis, which is a pronounced, or moderate, curving of the upper back. There is more than one cause, but the most common is vertebral compression fractures, which often occur with osteoporosis. Severe kyphosis is a health concern. It can be debilitating and will create an obvious spinal curve.

Risks

Vertebroplasty is generally considered a safe and appropriate non-surgical minimally invasive procedure for most patients with chronic back pain, caused by vertebral compression fractures. However, as with any procedure there are potential risks.

Some of the risks common the leakage of bone cement outside the vertebral body. This is extremely rare, and so is, infection, bleeding, numbness, tingling, headache, and paralysis may result from misplacement of the needle or bone cement.

Bone cement misplacement is made far less common by the usage of fluoroscopy or x-ray, or other radiological imaging devices to ensure proper placement of the bone cement and needle.

Vertebroplasty as a safe treatment for painful vertebral compression fractures, and complications are rare with the procedure (DaFonseca 2006) (Hiwatashi 2007)

Outcomes

Fracture Prevention

Overall good health can prevent factures. This includes, eating balanced diet, regular exercise, weight lifting, calcium and vitamin D supplements are healing and preventive for the spine.

Bisphosphonates medications (Fosamax) may prevent additional compression fractures, due to osteoporosis, by strengthening bones and preventing further bone density losses.

Those suffering from painful compression fractures, that have not responded to the prevantatives listed above,  may be good candidates for minimally invasive procedures like vertebroplasty and kyphoplasty (Old 2004).

For more information about Vertebroplasty or Kyphoplasty, or any other items mentioned, please see your pain physician.

Resources

  1. Vertebroplasty– PainDoctor.com
  2. Vertebroplasty and Kyphoplasty– PainDoctor.com
  3. Vertebral height restoration in osteoporotic compression fractures: kyphoplasty balloon tamp is superior to postural correction alone. Shindle MK, Gardner MJ, Koob J, Bukata S, Cabin JA, Lane JM. Osteoporosis Int. 2006 Dec;17(12):1815- 9. Epub 2006 Sep 16 PMID: 16983458.
  4. Balloon kyphoplasty in the therapy of vertebral fractures] DaFonseca K, Baier M, Grafe I, Libicher M, Noeldge G, Kasperk C, Meeder PJ. Orthopade. 2006 Oct;35(10):1101-9 PMID: 17195295.
  5. Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Boswell MV, Trescot AM, Datta S, Schultz DM, Hansen HC, Abdi S, Sehgal N, Shah RV, Singh V, Benyamin RM, Patel VB, Buenaventura RM, Colson JD, Cordner HJ, Epter RS, Jasper JF, Dunbar EE, Atluri SL, Bowman RC, Deer TR, Swicegood JR, Staats PS, Smith HS, Burton AW, Kloth DS, Giordano J, Manchikanti L.
  6. American Society of Interventional Pain Physicians. Pain Physician. 2007 Jan;10(1):7-111 PMID: 17256025 Vertebroplasty for osteoporotic fractures with spinal canal compromise Hiwatashi A, Westesson PL. AJNR Am J Neuroradiol. 2007 Apr;28(4):690-2 PMID: 17416822
  7. Treatment of painful osteoporotic or traumatic vertebral compression fractures by percutaneous vertebral augmentation procedures: a nonrandomized comparison between vertebroplasty and kyphoplasty. De Negri P, Tirri T, Paternoster G, Modano P. Clin J Pain. 2007 Jun;23(5):425-30 PMID: 17515741.
  8. Vertebral Compression Fractures in the Elderly. Old, Jerry; Calvert, Michelle. American Family Physician. January 1, 2004