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Vertebroplasty

(Percutaneous Vertebroplasty)

Procedure overview

Vertebroplasty is a procedure in which a special medical-grade cement mixture is injected into a fractured vertebra. The vertebrae are the small bones that make up the spine. When they become fractured, you will often experience pain and a loss of mobility.

When vertebroplasty is successful, the cement mixture injection stabilizes the vertebra and allows you to return to normal activity after a recovery period.

Reasons for the procedure

The main reason you would need a vertebroplasty is treat a fractured vertebra in your spine that’s causing pain and reduced function. Not all people with fractured vertebrae are candidates for a vertebroplasty, however.

Your doctor may try other, more conservative methods of treating the pain first: bed rest, pain relievers, muscle relaxants, back braces, or physical therapy.

These are reasons that your doctor may consider a vertebroplasty for your fractured vertebra:

  • Traditional methods of treating your fractured vertebra or back pain fail.

  • You suffer from severe or prolonged pain or immobility.

  • The fractured vertebra has led to more serious complications, such as deep vein thrombosis, acceleration of osteoporosis, respiratory problems, loss of height, or other emotional or social issues.

Risks of the procedure

The vertebroplasty procedure is generally well-tolerated, with a low risk for side effects. The complication rate of vertebroplasty is about 1 to 3 percent, and most of these complications are minor.

Here are the risks factors associated with receiving a vertebroplasty:

  • Hemorrhaging

  • Rib or other surrounding bone fractures

  • Fever

  • Nerve root irritation

  • Infection

In a small number of people, vertebroplasty can actually worsen the pain for a few hours as the cement sets up. This complication is rare, however, and passes after a short time.

There may be other risks, depending on your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure.

Before the procedure

  • Your doctor will probably order an X-ray, take a complete medical history, and do a physical exam to determine the precise location and true nature of your vertebra-related pain.

  • Your doctor will likely also use MRI or CT scanning to see your spine in greater detail and help rule out other back problems.

  • Tell your doctor about all prescription and over-the-counter medications and any herbal supplements that you are taking.

  • Tell your doctor if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications before the procedure.

Based on your medical condition, your doctor may give you other specific preparation instructions.

During the procedure

These are the typical steps in a vertebroplasty procedure:

  1. You will likely be asked to remove your clothing and wear a medical gown.

  2. The procedure usually takes place in what is known as an angiography or interventional radiology suite.

  3. Depending on your needs, the doctor will give you sedation medication to relax you and keep you calm during the procedure.

  4. If you are in severe pain, general anesthesia may be required.

  5. Your doctor will use a continuous X-ray to guide the needle into your body to perform the procedure. Your body will be protected from any harmful effects from the fluoroscopy.

  6. The doctor injects the needle into the fractured bone.

  7. The doctor slowly injects the cement mixture into the vertebra.

  8. Depending on how the cement enters the vertebra, a second injection might be needed to completely fill it.

After the procedure, you will be probably lie flat on your back for one hour while the cement hardens.

After the procedure

Once the procedure is complete and the cement has hardened, you will likely remain in an observation room for an additional one to two hours. This will allow the doctor to make sure that the procedure was successful. You will then likely be able to stand and walk with little or no pain.

You may experience pain relief almost immediately after the procedure, but for some people it takes up to 72 hours. Your doctor may provide you with over-the-counter pain relievers to help ease the discomfort.

Before you are discharged from the hospital, the doctor will probably perform an assessment of your pain and check for any possible complications. You can also expect a follow-up office visit in the coming weeks to make sure that the procedure has continued to be successful for you.