What is vertebroplasty?
A vertebroplasty is a procedure used to treat compression fractures in your spine. Your vertebrae are the bones that make up your spinal column. They surround and protect your spinal cord. When one of your vertebra fractures, it collapses and can narrow the area around your spinal cord. This can lead to pain. In a vertebroplasty, your doctor injects an acrylic cement mixture into the fractured vertebra. The cement mixture fills in and strengthens the fractured vertebra to relieve pain.
A vertebroplasty is a minimally invasive procedure. Your doctor may only consider this procedure if other options with less risk of complications have failed. These may include bed rest, pain medication, back braces, and physical therapy for several weeks without satisfactory back pain relief. Vertebroplasty is most likely to be successful when used within eight weeks after a vertebral compression fracture.
A vertebroplasty is only one method used to treat a vertebral compression fracture. Discuss all of your different treatment options with your doctor to understand which options are right for you.
Why is vertebroplasty performed?
Your doctor may recommend a vertebroplasty to treat vertebral compression fractures in your spine. Vertebral compression fractures occur when your vertebral bones become weak.
Your doctor may recommend vertebroplasty to treat the following conditions:
- Malignant or cancerous fracture. Cancerous tumors can weaken your vertebral bones, putting you at risk for vertebral compression fractures.
- Osteoporotic fracture. Osteoporosis leads to a loss of bone mass and bones that are porous. This weakens your bones and puts you at risk for vertebral compression fractures.
- Reinforcement of a vertebral bone or multiple vertebrae before a surgical stabilization procedure
- Vertebral hemangioma, which is an abnormal overgrowth of blood vessels within a vertebra
- Vertebral osteonecrosis, which is bone death. Osteonecrosis is a rare condition.
- Weakened vertebrae when you are too frail or your bones are too weak for open surgical repair
Who performs vertebroplasty?
The following specialists perform vertebroplasty:
- Neurosurgeons specialize in the surgical treatment of diseases and conditions of the nervous system, including the nerves of the spine.
- Orthopedic surgeons specialize in surgical treatment of diseases and conditions of the muscles and bones, including the spine.
- Interventional radiologists and vascular radiologists specialize in diagnosing and treating diseases using radiation and other imaging technologies.
- Neuroradiologists specialize in diagnosing and treating diseases and conditions of the brain, spine, head, neck and nerves using radiation and other imaging technologies.
The doctor most likely to perform your vertebroplasty is an interventional radiologist.
How is vertebroplasty performed?
Your vertebroplasty will be performed in an outpatient radiology facility or in a hospital. It takes about an hour for one vertebra and generally includes these steps:
- You will dress in a patient gown and lie on a procedure table.
- Your imaging team will insert an IV to provide fluids and medications.
- Your imaging team will attach devices to monitor your vital signs.
- You will receive medication (a moderate sedative) to relax you. If you are in extreme pain from your vertebral compression fracture, you may receive general anesthesia.
- You will lie face down to expose your spine. You will receive pillows and supports to provide comfort and help keep you positioned properly.
- Your imaging team will shave, clean and cover the affected area of your spine with a surgical drape.
- Your radiologist will numb the skin and muscles with an injection of local anesthetic.
- Your radiologist will insert a needle through your skin and into your fractured spinal vertebra. Real-time X-rays will guide proper needle placement. During the procedure, your radiologist will ask you questions about your pain.
- Once the needle is in place, your radiologist will inject medical-grade cement into your vertebra and then remove the needle. The cement hardens within 15 to 20 minutes.
- The radiologist repeats the process for each fractured vertebra.
- The imaging team may take additional X-ray images once the injections are complete.