Vertebroplasty is a minimally invasive technique that injects natural cement at the vertebral body level through a puncture from the skin. The most frequent vertebral fractures are osteoporotic origin, related to minor trauma. A vertebral fracture can also be related to more severe trauma or benign or malignant tumor processes.
Why is vertebroplasty performed?
The main goal of vertebroplasty is to relieve pain caused by a vertebral fracture. This technique is usually recommended when other conservative treatments, such as rest, corset placement, or medication, have failed to resolve the pain.
Once the ineffectiveness of these treatments has been seen, vertebroplasty should be performed as soon as possible to have a greater chance of success.
How do I know if I need vertebroplasty?
A complete clinical evaluation must be performed to confirm that the existing pain is related to the presence of a vertebral fracture. Likewise, some magnetic resonance imaging test or scintigraphy should be performed to verify the existence of said fracture at the level where the pain exists and that it is an acute fracture, thus increasing the technique’s effectiveness.
What are the risks and benefits?
Benefits: It is a minimally invasive procedure. It is performed through a puncture (usually two per vertebra) in the skin, with a needle that ends up being placed in the vertebral body.
When the indication is correct, it is a procedure that has a high degree of effectiveness when it comes to removing pain in less than 24 hours, thus achieving that the patient returns to normal activities of daily life as soon as possible. Regaining mobility also enables these patients to combat further bone loss in the future.
Risks: Any procedure that involves access through the skin carries a risk of infection. However, this possibility is estimated at less than 1 in 1000 procedures. Therefore, an intravenous antibiotic is administered preventively before the procedure.
A small amount of cement can leak beyond the vertebral body, being asymptomatic in the vast majority of cases. If this cement affects and compresses the spinal cord and migrates to the lungs, it could cause a severe problem. Other possible complications consist of bleeding, increased pain, or the appearance of new fractures.
In approximately 10% of patients, vertebroplasty can lead to the formation of new fractures; in that case, after a variable period of improvement,
Where and how is the procedure performed?
This is why an X-ray machine with the highest possible performance is needed to guarantee a correct visualization of the bone structures. Likewise, sterile conditions are essential during the procedure, which minimizes the risk of infection.
How is the postoperative?
The postoperative period is fast and straightforward if there are no complications. After the process, the patient will remain in bed, in absolute rest for 6-8 hours. Hospital admission will be approximately 24 hours, and after discharge, you can immediately return to normal activities, depending on the technique’s effectiveness in relieving pain.