What is Vertebroplasty?

Vertebroplasty is an invasive treatment for the relief of back pain that has been caused by the compression or fracture of a vertebral body in either the thoracic or lumbar spine. Vertebroplasty involves placing bone cement into the fractured vertebral body.

How is Vertebroplasty performed?

During the course of the procedure, a person lies on his or her stomach and a needle is placed into the vertebral body of the spine from the back. Real-time x-ray fluoroscopy is used to monitor the placement of the needle into the bony part of the spine. Bone cement mixed with a small amount of inert barium is infused into the vertebral body through the needle. This processed is watched with x-ray throughout the entire procedure. Once a sufficient amount of bone cement has been placed- almost filling the vertebral body- the needle is removed. The person remains on his or her stomach for about twenty minutes while the cement begins to harden. Then, the patient is turned over and lies on his or her back for up to two hours while the cement reaches its ultimate strength.

Will your physician recommend this procedure for you?

The vertebroplasty is usually recommended for the treatment of painful compression fracture of the thoracic or lumbar spine. The fracture may be due to any number of causes including trauma or tumor. However, the most common cause for compression fracture of the spine is osteoporosis. The diagnosis usually begins with a trip to your primary care physician. Your physician can often determine the cause of the back pain and initiate therapy. If numbness or weakness are present, you may be referred to a neurology or spine specialist.

The diagnosis of compression fracture is frequently made from an x-ray. Most individuals then obtain an MRI scan of the affected area. The MRI scan helps to determine the age of the fracture and whether or not something else may be causing the pain. Slipped disc and muscle tears may also cause back pain. These can be seen on an MRI. Only the compression fracture of bone is amenable to treatment with vertebroplasty. Some people cannot have an MRI scan because of the presence of pacemakers or aneurysm clips. These individuals may undergo CT scan (with or without x-ray dye) and a bone scan.

How Should I Prepare?

All individuals about to undertake a vertebroplasty should discontinue (under the direction of their primary care physician) any aspirin (one week) and blood thinners (3-5 days) prior to the day of the procedure. On the evening prior to the procedure, you should not eat or drink anything after midnight. Your radiologist will describe the procedure and any potential risks. He will answer any questions you may have about the procedure as well as your expected post-operative recovery.

Once in the x-ray suite, you will be comfortably positioned on your stomach. You will be given pain medication and a mild sedative through your IV until you are comfortable. You will be monitored by the physician and nurse throughout the entire procedure, until you arrive at the recovery room at the conclusion of the procedure. After 1 to 2 hours in the recovery room, you will be discharged with instructions and phone numbers of whom to call for any problems. All patients are directed to follow-up with their primary care physician in about two weeks after the vertebroplasty. The radiology staff will usually call in 1 to 2 days to see how you are doing.

Are there potential side effects or complications?

There is a small risk of infection or bleeding with any invasive procedure. Antibiotics will be given to minimize these risks. Furthermore, since the bone cement is introduced into the vertebral body as a liquid, there is the potential for the cement to leak through a fracture. Depending on the location and amount of the leak, one might have no symptoms or a potential worsening of the back pain. Worsening back pain or neurologic symptoms could require surgical correction. By far and away, most leaks are very small and have no adverse symptoms.

What can I expect?

Approximately 80% of treated patients have improvement in their symptoms with significant pain reduction within 48 hours. Should you have any questions regarding your exam, we will be happy to discuss them with you.