What Is Percutaneous Vertebroplasty?
Percutaneous vertebroplasty is a minimally invasive procedure used to help alleviate pain and improve mobility for people with compression fractures of the vertebra, generally caused from osteoporosis or spinal tumor. Pain, associated with compression fractures, is largely due to bone rubbing on bone during movement. Under fluoroscopic (X-ray) guidance a needle is inserted into the fractured vertebra. Once in place, bone cement is injected into the vertebra. Once the cement hardens this helps to stabilize the bone and helps to prevent further collapse.
The procedure may be performed on an outpatient basis. Patients are required to check in 30 minutes prior to their scheduled appointment time. Once taken back to the preparation area, a small IV catheter will be placed in your hand or arm. This catheter may be used to administer light sedation for the procedure. When taken to the procedure room, you will be placed on your stomach. Blood pressure and oxygen saturation monitors will be applied. The injection site will be cleansed with an antiseptic solution and draped in a sterile manner. Using a small, thin needle, local anesthetic is injected to numb the skin and deep tissue, which may feel like a stinging and/or burning sensation. Assisted by fluoroscopy (X-ray), a needle is inserted in to the fractured vertebra and bone cement is injected into the vertebra. Once the cement hardens this helps to stabilize the bone and helps to prevent further collapse. The procedure may take approximately 1 hour to perform. Post-operatively, the patient is to remain supine (flat on back) for 1 hour; followed by 4 hours of bed rest.
Most people experience significant pain relief within 24 hours after the procedure and many can resume their normal daily activities immediately thereafter. Once the procedure is over, you will be taken to a recovery area, where you will be monitored for 15-30 minutes and released to go home. You MUST have someone available to drive you home. Failure to have a driver may result in your procedure being rescheduled.
- Elderly female
- Weight less than 125lbs
- Cigarette smoking
- Physical inactivity
- Chronic steroid use
- Chronic alcohol use
Compression fractures may occur while lifting, coughing, sneezing, bending, and arising from a chair or bed. Pain may be sudden or develop over several days. The pain may increase in intensity with routine activities, especially standing or sitting, and is generally eased with bed rest. The pain may radiate to the abdomen and chest accompanied by a loss of appetite or the feeling of abdominal fullness.
Potential complications of this procedure include, but are not limited to:
- Migration of the cement into the epidural veins
- Leakage of cement through the fractures into the spinal canal causing spinal cord and/or nerve root compression
- Cement embolism to the lungs
- Pneumothorax (punctured lung)
- Rib fractures
- Posterior element or pedicle fracture