ABOUT
Vertebroplasty is the procedure by which bone cement is injected into the vertebral body to provide strength to the weakened vertebra. Old patients with weak bones, bones shrunk due to the previous fracture, simple bone tumours are some common indications for which it is indicated. It is a minimally invasive procedure for the treatment of painful vertebral compression fractures that occur in old age due to osteoporosis.
When a vertebral body fractures, the usual rectangular shape of the bone becomes compressed, causing pain. These compression fractures may involve one or more vertebrae in the spine and are a common result of Osteoporosis. Vertebral compression fractures can also due to bone weakening following primary cancer such as myeloma or secondary cancer spread (metastasis).
INDICATIONS
Vertebroplasty and kyphoplasty are used to treat painful vertebral compression fractures in the spine, most often the result of osteoporosis. They are recommended after less invasive treatments, such as bed rest, back brace or pain medication, have been ineffective. Patients who develop non-union (pseudoarthrosis) of the vertebral fracture after medical treatment of the fractures are ideal candidates for the technique. Vertebroplasty and kyphoplasty are also performed on patients who have vertebral compression due to a malignant tumour and osteoporosis due to long-term steroid treatment or metabolic disorders such as hyperparathyroidism. These techniques are preferably performed within eight weeks of the acute fracture for optimal surgical results. While vertebroplasty provides pain relief by stabilising the fracture, kyphoplasty can restore the original height of a fractured vertebra. Both techniques have equivalent functional outcomes.
PROCEDURE
The procedure is of short duration (30 minutes) and usually done under general or local anaesthesia. In vertebroplasty, the surgeon uses image guidance technique to inject a cement mixture into the fractured bone through a percutaneously inserted needle. In kyphoplasty, a balloon is first inserted into the fractured bone through the hollow needle to create a cavity or space into the fractured vertebra. The cement is injected into the cavity once the balloon is removed.
Two small stitches are usually put which can be removed on an out-patient basis, ten days after the procedure. Patients are usually made to walk from the next day. The patient is discharged on the second day as most patients are pain-free by then. During sitting and walking, patients have to wear a belt at least for a period of two months. Most patients return to their routine pre-hospital lifestyle in a week to ten days.