Vertebroplasty

What is vertebroplasty?

Vertebroplasty is a procedure used to treat fractures or breaks in the vertebrae. The vertebrae are the bones in your back that are stacked on top of each other to make your spine. Your spine supports your weight, allows you to move, and protects your spinal cord and nerves.

In vertebroplasty, your healthcare provider injects a special thick cement mixture into a fractured vertebra. When vertebroplasty is successful, the cement mixture stabilizes the vertebra and allows you to return to normal activity after a recovery period.

Why might I need vertebroplasty?

The main reason you would need a vertebroplasty is to treat a fractured vertebra in your spine that’s causing pain and reduced ability to function. But not all people with fractured vertebrae are candidates for this procedure.

Your healthcare provider may try more conservative ways to treat the pain during the first 6 weeks after the fracture. This may include bed rest, pain medicines, muscle relaxants, back braces, or physical therapy.

These are common reasons that your healthcare provider may consider a vertebroplasty for your fractured vertebra:

• Traditional methods of treating your fractured vertebra or back pain are not working.

• You suffer from severe or prolonged pain or immobility.

• The fractured vertebra has led to more serious complications, such as deep vein thrombosis (blood clots in your legs), breathing problems, loss of height, or other emotional or social issues.

• The fracture was caused by osteoporosis, which means you are at a higher risk for more fractures.

What are the risks of vertebroplasty?

Vertebroplasty is generally well-tolerated and low risk. These are the more common risk factors associated with this procedure:

• Bleeding

• Surrounding vertebral fractures

• Increased back pain

• Fever

• Tingling, numbness, or weakness because of nerve damage

• Infection

• Cement leaking out of position and compressing other organs or the spinal cord

In a few people, vertebroplasty can actually worsen the pain for a few hours as the cement sets up. This complication is rare, though, and passes after a short time.

There may be other risks, depending on your specific health condition. Talk about any concerns with your healthcare provider before the procedure.

How do I get ready for vertebroplasty?

Your healthcare provider will probably order X-rays, take a complete medical history, and do a physical exam to determine the exact location and true nature of your vertebra-related pain.

Your healthcare provider will likely also need an MRI or CT scan to see your spine in greater detail and help rule out other back problems.

Tell your healthcare provider about all prescription and over-the-counter medicines and any vitamins, herbs, and supplements that you are taking.

Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any blood-thinning (anticoagulant) medicine, aspirin, or other medicines that affect blood clotting. You may be told to stop these medicines before the procedure.

You may be told to not eat or drink anything for several hours before the surgery. Bring someone with you to the procedure to drive you home afterward.

Talk to your healthcare provider about what you need to do before your procedure.

What happens during vertebroplasty?

An anesthesia provider will put an IV line into a vein in your hand or arm to give you medicine. You will either be given medicine to relax you and keep you from feeling pain or to make you go to sleep during the procedure. You will lie face down on an operating table during the surgery. X-ray equipment will be nearby.

The healthcare provider will put a needle through your skin and back muscles and into the spinal bone (the vertebra). Next, your healthcare provider will inject the cement mixture into the bone. While this is done, he or she will check X-ray images to help ensure that the cement goes into the right place. Depending on how the cement enters the vertebra, you may need a second injection to completely fill it. The healthcare provider will then remove the needle. You will not need stitches in your back.

The entire procedure will probably take less than an hour. If the healthcare provider needs to treat more than one vertebra, it may take longer. You will spend time in a recovery room after the surgery. You will probably lie flat on your back for about an hour while the cement hardens. You may be able to go home the same day, but your healthcare provider might want you to stay overnight.

Talk with your healthcare provider about what to expect during your vertebroplasty.

What happens after vertebroplasty?

You may be able to start walking about an hour after the procedure. It’s normal to feel some soreness where the needle was put into your back. This might last a few days. You may notice right away that you have less pain in your back than you did before the surgery. Talk with your healthcare provider about whether you should avoid any activities after the procedure.

You may have pain relief almost immediately after the procedure, but for some people it takes up to 72 hours. Your healthcare provider may provide you with pain relievers to help ease the discomfort.

If the fracture was caused by osteoporosis, your healthcare provider may suggest that you take certain vitamins, minerals, or medicines to help strengthen your bones and help prevent more fractures in your spine.

Your healthcare provider may give you other instructions about what you should do after your procedure. Be sure you understand the instructions and how to use any prescription medicines you’re given. Also know how to reach the healthcare provider if you have any problems and when your next appointment is scheduled.

Next steps

Before you agree to the test or the procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure