A vertebroplasty is a minimally invasive spine procedure that involves injecting bone cement into a vertebral fracture. The fractures in the spine are typically caused by osteoporosis. They may also be the consequence of cancer.
Prior to the invention of vertebroplasty, one of the main ways to unprotected to pain relief from a fracture was with an external back brace. This would often help but can be bothersome for patients and if it’s hot outside may be unable to use it. The vertebroplasty procedure with its cement acts as an internal brace and may relieve pain quickly and efficiently.
The procedure is performed typically in an outpatient setting, although in-patients can receive it as part of treatment. The patient is positioned confront down on a comfortable table, and usually receive some sort of IV sedation to prevent pain and movement. The surgeon places a guidewire under fluoroscopy towards the spine. The entry point into the fracture can be on either side of the spine by an area called the pedicle.
Once inside the fracture area, often times a bit of bone is removed, called a biopsy, and is sent to the pathology lab for evaluation to see if it is a simple osteoporosis fracture or something more serious, like myeloma or a metastatic cancer. At that point, bone cement is mixed up and inserted into the fracture area. Whether or not to inject cement on both sides is surgeon dependent.
This stabilizes the fracture and provides moment pain relief to the great majority of patients. This is now an internal cast which provides for the pain relief and rapid ability to ambulate. Patients can get out of bed, preventing pneumonia and other problems. In conjunction with later physical therapy and maybe other pain management treatments, a vertebroplasty may dramatically help a patient with a vertebral fracture.