Overview:
Vertebroplasty is the procedure of injecting special bone cement into fractured vertebrae to relieve spinal pain. It is an outpatient procedure, which means the patient can expect to go home on the same day the surgery takes place.
Compression fractures in the spine often occur because of osteoporosis, leaving them cracked or broken. The injected cement stabilizes such fractures on hardening and provides the spine with much-needed support.
This procedure helps relieve back pain and increases mobility.
Alternate name:
Scientific name: Percutaneous vertebroplasty
Alternate name: percutaneous vertebral augmentation
Body location:
Vertebrae of the spinal cord
How it is performed:
During the surgery, the patient is sedated and is laid face down for the surgery. In case of severe pain, general anesthesia is administered during the surgery.
With the help of a continuous X-ray guidance, the doctor guides a biopsy needle at a certain angle to reach deep within the vertebral body position of the needle is confirmed with the help of X-rays.
Bone cement of low-viscosity (PMMA) is slowly injected into the fractured vertebra and spread around the weakened portion. Depending on how fast the cement enters and spreads, a second injection may or may not be required to fill it entirely.
As the cement hardens, it creates an internal cast on the inside of the damaged vertebra and stabilizes it. The hardening of the cement takes 5-10 minutes depending on the cement used, after which the same is repeated on the other side of the vertebral body.
The punctured skin is covered by a bandage once the surgery is completed.
Preparation:
Here are a few things to remember before surgery:
- No food or drink is allowed less than 6 hours before the procedure.
- A small amount of water may be allowed up to 2 hours before the surgery.
- The doctor checks an X-ray along with the patient’s complete medical history. Apart from this, the doctor conducts a physical exam to ascertain the exact location and the nature of the pain.
- An MRI or CT scan may also be requested, depending on the nature of the diagnosis.
- Based on the patient’s medical history, certain medications will be discontinued or have their dosages adjusted before the surgery.
- A history of bleeding disorders and blood-thinning medications, aspirin, or blood clotting medications, need to be specially mentioned to the consulting physician.
- Avoid or reduce tobacco or alcohol consumption habits as they will affect bone healing once the surgery is completed.
Procedure type:
Minimally invasive, percutaneous vertebroplasty
Follow-up:
After the surgery is completed, the patient is kept under observation for 1-2 hours.
Patients are required to lie on their backs during this time after surgery before trying to attempt any movement. This period will give the cement time to harden.
Sometimes, the patient experiences immediate relief after the surgery. However, it may also take up to 72 hours after the surgery.
The doctor can prescribe over-the-counter pain relievers to alleviate brief discomfort.
A back brace may be prescribed to assist with regular movements for a while. Usually, it is not required.
Before discharge, the doctor will check for possible complications and assess the patient’s pain before letting them leave the hospital.
As it is an outpatient surgery, the patient is most likely to leave the hospital on the same day as the surgery.
The needle wound can be iced in case the pain persists.
Risks:
Spinal surgeries come with certain risks. They include:
- Loss of blood
- Infections
- Blood clots
- Allergic reactions to medicines
- Nerve root irritation or injuries
- Leakage out of cement before it hardens
This minimally invasive surgery ensures less pain and increased mobility, allowing the patient to enjoy a better quality of life.
Recovery:
The patient can mobilize and continue daily activities at home with help of brace. Though walking won’t be an issue, it can be avoided during this time.
On completing the first 24 hours without any complications, the patient can resume their daily activities slowly.
Strenuous exercises and heavy lifting must be avoided for a minimum of 6 weeks from the surgery.
Slip-on shoes are the patient’s best friend during this time. Bending to tie their shoes can be easily dodged and provide relief.
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