VertebroplastyVertebral fracture is not always a serious event, although it sounds terrible. Many breaks in spinal bones actually do not require any treatment, since they will heal fine on their own. However, in cases where treatment is needed, or if spinal instability or neurological risk exists, then this surgical intervention may be one possible approach to indicated care. Vertebroplasty ProcedureVertebral repair is a minimally invasive outpatient procedure performed under local anesthetic. The technique involves a small incision in the skin. The surgeon will view the fractured spinal bone under live X-ray (fluoroscopy) to monitor progress of treatment during the operation. A needle is inserted directly into the bone fracture. Special cement called PMMA (polymethylmethacrylate acrylic cement) is injected into the fractured vertebrae. The cement will harden in less than 15 minutes and provide immediate stability to the fracture. After the orthopedic surgeon is sure that the vertebrae has been adequately reinforced, the needle is withdrawn and the incision closed. The procedure takes less than 1 hour total and the patient can go home immediately. As long as no unforeseen complications occur, the patient should not suffer anything worse than a bit of soreness from the procedure.Risks of Vertebroplasty
There are some standard risks of
surgical complications,
such as bleeding or infection. There are also specific
back surgery risks
in this procedure that involve the PMMA cement. This material is not approved by the FDA. So far, no substance has passed federal safety testing for injection into a vertebral bone. There is a moderate risk of leakage of the cement, prior to it hardening. If it does leak, it can compress
spinal nerves,
causing serious neurological problems, such as nerve damage. It is possible for the cement to get into the blood supply, causing heart or lung problems, or even death. It may also enter the cerebral spinal fluid, also causing dire health effects. Recommendation for VertebroplastyThis is an excellent minimally invasive procedure for correcting minor vertebral fractures. The success rate is close to 90% for indicated cases. This procedure is most often used when the fracture is small and contained.Obviously, consider all varieties of back surgery as a last resort and make sure to research the procedure and surgeon carefully to optimize the chances for a successful result. Some patients are recommended to undergo surgical correction of fractures unnecessarily. If the break will heal fine naturally, then that is the preferred course. Surgical correction is best left for cases in which the patient, or the fracture, demonstrates unusual circumstances which will prevent typical and full resolution of the break. Additionally, some patients may have a difficult time accessing this procedure, due to the risks of the PMMA cement and the reluctance of care providers to deal with the legal liabilities of treatment. Vertebroplasty to Back Pain 7/1/06 Revised 11/5/11 |
Sensei Adam Rostocki
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