What is vertebroplasty?
Patients suffering back pain from spinal compression fractures may be candidates for a relatively new procedure called percutaneous vertebroplasty or PVP.
Percutaneous means, "through the skin." Vertebroplasty means, "fixing the vertebral body."
Vertebroplasty consists of injecting sterile liquid bone cement into the fractured vertebral bodies of the spine. The fast drying cement fills the tiny holes and crevasses and stabilizes the collapsed vertebrae.
How’s it done?
Vertebroplasty is a minimally invasive, non-surgical procedure most often performed by an interventional neuroradiologist. It’s the neuroradiologists' expertise with fluoroscopic guidance that makes him the obvious choice.
For the procedure, the patient is given a local anesthetic while lying on their stomach. A bone needle is then inserted through the skin and guided into position within the crushed vertebrae.
With the aid of a fluoroscopic imaging tool such as the Philips Integris biplane interventional system, the needle's position can be carefully calculated and adjustments made. Upon insertion of the needle, a ‘venogram’ is performed. A dye is injected into the bone and a radiographic image taken to confirm positioning. This digital imaging can assist a properly trained physician to move quickly and accurately through the vertebroplasty procedure.
Once the needle is in the right place, a fast drying surgical bone cement called polymethyl methacrylate is injected into the bone to stabilize it.
How long does it take?
The entire procedure can take about one hour for each vertebra involved. Often more than one vertebra is treated in a single procedure. Usually a CT scan is ordered upon completion. This is done to document the results of the procedure and to make certain the distribution of the cement is optimal. (While CT requires the patient to move from one room to another, a timesaving, low dose alternative being used by leading neurologists, is 3D rotational angiography.)
The bone cement hardens within 15 minutes and the patient must remain at bed rest for a few hours. Upon physician review, release the very same day or next day is possible.
Many patients experience immediate relief of pain and can resume their normal daily activities within a short period of time.
(Published September 21, 2004)