What is percutaneous vertebroplasty?
Percutaneous vertebroplasty (PVP) is a procedure used to treat and stabilize vertebral (spinal) fractures. The process involves using a type of imaging called fluoroscopy, which provides X-rays in real time, to enable a doctor to inject a concrete-like fast-setting polymer into the damaged vertebrae.
A procedure called kyphoplasty often accompanies vertebroplasty. Kyphoplasty is the insertion and inflation of a balloon in the vertebrae before the cement delivery. This helps to repair loss of height in fractured vertebrae and restore alignment.
The doctor may use a SpineJack kyphoplasty system, which uses titanium implants in the bone that work together in the bone with the cement-like polymer to create a more stable outcome, reduce post-procedure pain, and better restore vertebral body height.
What is percutaneous vertebroplasty used for?
Percutaneous vertebroplasty is used to:
- Treat pain in vertebral (spinal) compression fractures
- Treat collapsed vertebrae from osteoporosis
- Treat spinal damage due to certain cancers and spinal tumors
- Stabilize weakened vertebrae prior to surgery
- Help repair alignment of vertebrae due to kyphosis
- Pain from vertebral hemangioma
How do doctors perform percutaneous vertebroplasty?
Before the vertebroplasty is performed, the doctor will formulate a plan to best treat the damaged vertebrae. This may include:
- Medical history and physical exam
- CT scans
- MRI of the spine
- Blood tests
- Complete blood count (CBC)
- Chemistry panel
- Coagulation panel (PT/PTT)
The actual vertebroplasty procedure may last between 30 minutes to two hours.
- Patient is placed in the prone position (face down)
- The area of the back around the damaged vertebrae is cleansed thoroughly with antiseptics to prevent infection
- Anesthesia is administered for conscious sedation
- Local anesthesia (such as lidocaine with epinephrine) is placed in the back at the level of the damaged vertebrae using a needle
- X-rays are performed using fluoroscopy to ensure proper localization of the damaged vertebrae and to guide placement of the cement compound
After the procedure
- Patients are put on bed rest for up to 2 hours
- Pain medications may be given
- Muscle relaxants may be given for muscle spasms
- Patients receive detailed follow-up instructions
- Patients are usually discharged the same day with a family member or friend who can help them after the procedure.
Nearly everyone has low back pain at some time during their life.
What are Risks and Complications of Percutaneous Vertebroplasty?
Complications from vertebroplasty are usually minimal and only occur in 1% to 10% of cases.
Possible complications may include:
- Infection in the skin or vertebrae
- Worsening of spinal fracture, especially when the original fracture is due to cancer
- Damage to spinal cord or adjacent nerves
- Allergic reaction to anesthetic or cement-like compound
- Collapsed lung
- Cement migration – cement compound leaks into surrounding tissues or bloodstream