Lumbar or Thoracic Vertebroplasty
Vertebroplasty is a minimally invasive surgical procedure to treat vertebral compression fractures caused by weakened bones.
What are Vertebral Compression Fractures?
Vertebral compression fractures, or VCF's, occur when bones in the spine are broken. They can occur from trauma, such as a car accident or fall, but are most commonly the result of osteoporosis which causes weakened bones. VCF's can also occur from other conditions that cause weakened bones, such as certain cancers or long term steroid use.
Compression fractures occur most commonly in the mid to lower back due to the weight bearing load of the spine. This load can cause vertebrae to become crushed when bone weakness is present. When the vertebra is crushed, it fractures and falls on top of the vertebra below it. Symptoms range from severe pain to no pain at all.
Compression fractures can lead to progressive spinal deformity. When multiple fractures occur, a condition known as Kyphosis, or dowager's hump, causes the back to become rounded and bent forward. This forward curvature of the spine can affect quality of life making it more difficult to breathe, eat, walk, or sleep.
What is Osteoporosis?
Osteoporosis is a degenerative condition associated with aging that causes loss of bone mass. This leads to weakened and brittle bones that break easily by minimal trauma or by no trauma at all. Osteoporosis is most common in post-menopausal women but can also occur in older men or patients on long term steroid therapy.
Vertebroplasty Surgery is an elective surgery to treat painful compression fractures of the spine that have not responded to conservative treatment measures such as rest, medication, or back bracing.
Indications for Vertebroplasty surgery include:
- Vertebral Compression Fractures due to osteoporosis.
- Vertebral Compression fractures caused by weakened bones in patients with diagnoses such as Metastatic cancer, kidney disease, lymphoma, and multiple myeloma.
- Severe pain and deformity related to a vertebral fracture that is unrelieved by conservative treatments such as pain medications and bracing.
How is Vertebroplasty Performed?
Vertebroplasty is a minimally invasive surgical procedure to alleviate severe pain and disability resulting from vertebral compression fractures.
The ultimate goal of the surgery is to:
- Alleviate or reduce the patient's pain
- Restore the fractured vertebra to its pre-fracture height
- Improve spine functionality
- Restore normal alignment of the spine
The surgery is performed under sterile conditions in the operating room with the patient under general or local anesthesia and lying face down on the operating table.
Your doctor will make a very small nick in the skin over the fracture site.
Under live X-ray guidance, a hollow needle called a trocar is introduced through the back where it is positioned within the fractured vertebrae.
Medical grade bone cement is then injected into the area through the trocar.
X-rays or CT scans may be done to confirm effective distribution of the bone cement.
The trocar is then withdrawn, pressure is applied, and a sterile bandage is placed.
Many patients feel immediate pain relief following Vertebroplasty surgery. Others may take a few days or weeks before showing improvement.
Most patients are discharged to home the same day.
You should rest in bed for the first 24 hrs. but can get up to use the bathroom.
Pain medication will be given to make you comfortable for the first few days.
Ice packs can be applied to the insertion area for 15 minutes per hour placed over a cloth.
You will be restricted from heavy lifting or strenuous activities for the first 6 weeks.
A postoperative rehabilitation program may be prescribed by your doctor to strengthen spinal muscles after two weeks.
If you have been diagnosed with Osteoporosis, it is important for you to follow up with your physician for medical treatment of your condition.
Risks and Complications
Complications are very rare but are present and can be medical (general) or specific to spinal surgery.
Medical complications include those of the anesthetic and your general well being. Almost any medical condition can occur so this list is not complete.
Specific complications of Vertebroplasty surgery are rare but include:
- Nerve damage or spinal cord injury from leaking cement
- Deep or superficial wound infection
- Increased back pain
- Numbness and tingling
- Paralysis is very rare.