A person has 33 bones in the spine, called vertebra, that interlock to form the spinal column. As an adult ages, osteoporosis (a condition in which bones weaken) may cause vertebra to crack, leading to pain and loss of mobility. Tumors and conditions of the veins or arteries of the spine may also lead to vertebral fractures.
Vertebroplasty is a relatively new, minimally invasive procedure used to stabilize spinal fractures. In a vertebroplasty, an interventional radiologist injects glue-like bone cement into the cracked or broken vertebra. The cement stabilizes the cracked bone rapidly, providing pain relief and improving mobility.
Why Vertebroplasty is Performed
Vertebroplasty is most commonly performed on patients with osteoporosis. With this condition, bones become less dense and start to weaken. These weak bones are prone to fracture, and osteoporosis frequently affects vertebra.
A patient with a cracked back bone may initially be prescribed medicine to control pain and a period of bed rest. If these measures do not improve the symptoms of the fracture, a doctor may recommend vertebroplasty. Since the procedure is most effective with new fractures, patients suspecting a vertebral fracture should see a physician in a timely manner. Back issues like non-specific back pain or disc compression cannot be helped by vertebroplasty.
What to Expect During Vertebroplasty
To confirm that the cause of a patient’s back pain is a vertebral fracture, the physician will typically order an x-ray. If a fracture is confirmed, vertebroplasty may be recommended. This outpatient procedure takes about an hour per vertebral bone treated. Multiple fractures may be treated during one session.
After the patient receives sedation to help them relax, the spinal area is numbed with local anesthesia and a small incision is made in the patient’s skin. Next, the interventional radiologist inserts a needle with the assistance of x-ray imaging, which helps to ensure that only the fractured bone is safely accessed. From here, bone cement is injected directly into the fractured vertebra. The cement quickly fills the space created by the fracture, forming a cast to support the bone. It only takes minutes for the cement to harden. The stabilization effect and pain relief are nearly immediate.
Risks and Benefits of Vertebroplasty
The vertebroplasty procedure and the acrylic cement used to fill in the fractured vertebra are both safe. Patients often feel relief from vertebroplasty within hours, and are usually discharged home the same day. As with any medical procedure, there are potential complications such as bleeding and infection. Risks specific to vertebroplasty include allergic reaction to the cement or the leakage of the cement outside the intended area. There is also a minor risk that the needle could damage a nearby nerve, leading to temporary numbness or a tingling sensation.
How to Prepare for Vertebroplasty
Prior to the scheduled procedure, patients will talk with their care team about any other medical conditions and all medications they are taking. Some therapies, such as blood thinners, may need to be paused ahead of the procedure. Patients will be instructed on when to stop eating and drinking prior to the appointment. Because light sedation is used for vertebroplasty, patients will need to be driven home from the appointment, and should plan on resting for the remainder of the day.
Most patients are able to walk immediately following vertebroplasty, but should rest for the first day after the procedure. Pain will typically start to improve immediately following the vertebroplasty and continue to improve for the next two days. Patients should resume normal activities slowly and can treat any residual pain with pain relief medication. The care team will discuss how to minimize the chance of future fractures at a post procedure follow-up appointment.