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Spinal Structure and Function

The spine, also called the backbone, is designed to give us stability, smooth movement, as well as providing a corridor of protection for the delicate spinal cord. It is made up of bony segments called vertebrae and fibrous tissue called intervertebral discs.

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Vertebral Compression Fractures and Treatment

Vertebral compression fractures (VCFs) occur when spinal bones break, often due to osteoporosis, though trauma, certain cancers, or long-term steroid use can also be causes. These fractures are most common in the mid to lower back, where the spine bears the most weight, and symptoms can range from severe pain to none at all.

VCFs can lead to spinal deformity, including kyphosis (dowager’s hump), which may impair breathing, eating, walking, and sleep.

Vertebroplasty is an elective procedure for painful compression fractures that haven’t improved with rest, medication, or bracing. The goal is to relieve pain, restore vertebral height, improve function, and correct spinal alignment.

Indications

Indications for Vertebroplasty 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
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Diagnosis

Evaluating the source of back pain is critical in determining your options for pain relief and the location of where to perform surgery. Your doctor will take your medical history and perform a physical examination. Diagnostic Studies to confirm a vertebral fracture and its cause may include:

X-Rays

A form of electromagnetic radiation that is used to take pictures of bones.
MRI: Magnetic and radio waves are used to create a computer image of soft tissue such as nerves and ligaments.

CT Scan

This test creates 3D images from multiple X-rays and shows your physician spinal structures not seen on regular X-rays.

Bone Density Test

A test used to diagnose osteoporosis using special X-rays to determine bone density or strength.

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Procedure

  • 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.

Postoperative Care

Many patients feel immediate pain relief following vertebroplasty. 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 placed over a cloth can be applied to the surgical area for 20 minutes every hour. 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 two weeks after your surgery.
If you have been diagnosed with Osteoporosis, it is important for you to follow up with your physician for medical treatment of your condition.

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Risks

As with any major surgery, there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. Complications can be medical (general) or specific to spinal surgery. Specific complications of Vertebroplasty surgery include:

  • Nerve damage or spinal cord injury from leaking cement
  • Deep or superficial wound infection
  • Bleeding
  • Increased back pain
  • Numbness and tingling

Vertebroplasty is an elective surgery to treat painful compression fractures of the spine that do not respond to conservative treatment measures. Vertebroplasty reduces pain, restores the height of the fractured vertebra as well as normal alignment of the spine and improves spine functionality.

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Relief starts with quality orthopedic care. Contact us today to take the next step toward a more active, pain-free life.

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