Vertebroplasty, a minimally invasive technique for stabilizing compression fractures in the spine, helps restore bone height and also reduces pain. Vertebroplasty is done percutaneously, through a small incision in the back. Intravenous sedation helps the patient relax and local anesthesia numbs the area. Injected contrast dye helps visualize the area. A hollow tube inserted into the damaged vertebrae allows placement of special cement that stabilizes the fracture. After one to two hours lying flat to allow the cement time to harden, the patient goes home and can resume normal activity, usually within 24 hours after the procedure, RadiologyInfo.org states.
Indications
Percutaneous vertebroplasty is recommended for people with painful or disabling vertebral fractures that haven't responded to medical therapy. A person with vertebral damage from malignant tumors of the spine may also benefit from the surgery. Vertebroplasty may also benefit frail or elderly patients unable to undergo more extensive surgical procedures.
Contraindications
Not everyone should undergo vertebroplasty. Contraindications include a fracture that's healing well or responding to medical therapy, untreated coagulopathy or problems with blood clotting or presence of infection. Fractures over one year old or fractures where 80 to 90 percent of the vertebral body has collapsed also may not benefit from the procedure, lead author Thomas Predey, MD of LaGrange Memorial Hospital reported in 2002 in the American Academy of Family Physicians journal, "American Family Physician."
Benefits
The benefits of vertebroplasty include decreased pain, with less need for pain medication, increased ability to function and stabilization of the spine, which helps prevent another fracture from occurring in the vertebrae, MayoClinic.com explains. About 75 percent of patients undergoing vertebroplasty have improved mobility, which helps maintain bone strength, RadiologyInfo.org states. Vertebroplasty also leaves no surgical scar, since the procedure requires only a small incision in the back that doesn't need stitching. Pain relief occurs in between 73 to 90 percent of patients in various studies, Dr. Predey notes.
Complications
Fewer than 1 in 1,000 people develop infection after vertebroplasty, RadiologyInfo.org reports. Other potential complications include allergy to the contrast dye used for visualization, cement leakage, bleeding and numbness and tingling around the area from nerve damage. Paralysis can occur in very rare cases. Cement leakage can cause problems if it enters the spinal canal. Complications occur more frequently in people undergoing vertebroplasty to repair damage from cancerous lesions in the spine, Predey states, with a complication rate of 7 to 10 percent compared to 1 to 3 percent of people with osteoporosis.
