Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine
Following a vertebral fracture, vertebroplasty can be considered if previously attempted methods fail.
What is vertebroplasty, and when should it be considered? Does this intervention involve any risks? How does the procedure take place ?
This popularized article explains everything you need to know if your doctor (or yourself) ever considers this infiltration.
Contents
Definition
Vertebroplasty is an operation during which a special cement is injected into a vertebrate fractured. It is considered a minimally invasive surgery because it does not involve incision of the skin.
The bone cement then fills the cracks in the vertebra to create a kind of “internal plaster”.
The main objective is to stabilize a fracture by vertebral compaction (for example, due to theosteoporosis). This relieves spinal pain, regains mobility and regains function.
The success rate is almost 75%. However, it is not suitable for all vertebral fractures. It is also not indicated for herniated discs or osteoarthritic pain.
Procedure
Following a vertebral fracture, the doctor will determine if the patient is a candidate for vertebroplasty. He will take into consideration the medical history, associated conditions, type of fracture, and results of themedical imaging.
Ideally, vertebroplasty should be performed no more than 8 weeks after the vertebral fracture. After this time, healing will have already begun, and the procedure may not be as effective.
The intervention as such lasts approximately one hour. It is preceded by local anesthesia, a sedative or general anesthesia (depending on the patient). The place where the infiltration will take place is then sterilized.
Vertebroplasty is guided by an X-ray throughout the procedure. This allows the infiltration to be guided in real time so that it reaches the fractured vertebra.
Once the fractured vertebra is located, cement is injected into the vertebra. Polymethyl methacrylate (PMMA) is mainly used. Sometimes subsequent infiltrations are needed to fill the vertebra with cement.
Following the procedure, the patient is kept under observation for a period of up to 2-3 hours. Although symptoms may be relieved immediately after vertebroplasty, it is not uncommon to experience more pain immediately afterwards. Pain medication will be prescribed to combat this temporary pain.
The patient generally leaves the office the same day. It is estimated that the therapeutic effect will be at its peak about 72 days after the procedure. A gradual return to activities and work can then be initiated.
A follow-up appointment is usually made some time after the vertebroplasty.
Alternatives to vertebroplasty
Following a vertebral fracture, vertebroplasty is not immediately indicated. Indeed, more “conservative” approaches are initially attempted. This may include:
- Bed rest
- Medications (analgesics, relaxants)
- Corset
- Physiotherapy (physiotherapy)
- Kyphoplasty
It is only when the treatments mentioned above fail that vertebroplasty is considered.
More specifically, if the pain persists and limits activities following a vertebral fracture, we will then consider vertebroplasty.
It can also be considered if the vertebral fracture has caused serious complications such as venous thrombosis, osteoporosis, respiratory problems or others.
Complications
Although rare (less than 4% of cases), vertebroplasty comes with its share of potential complications. This includes:
- Haemorrhage
- Blood loss
- Rib fractures
- Fever
- Irritation of nearby nerve roots
- Muscle weakness or paralysis (impairment of the spinal cord)
- Infection
- Flow of injected cement
Resource
Forum discussing vertebroplasty
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