The vertebroplasty method is known and has been used for many years to "strengthen" a weak vertebra, whether the reason for its weakness is a fracture due to osteoporosis or metastatic disease of the spine due to malignant diseases.
Vertebroplasty is performed by inserting a needle with a diameter of about 1.5 mm, which is inserted into the body of the vertebra by means of a puncture through the skin and under the control of a diascopic apparatus, a liquid so-called "bone cement(PMMA, polymethyl methacrylate) which hardens after drying and thus "strengthens" the diseased vertebra. When performing vertebroplasty, bone cement is mostly used, the "liquid phase" of which lasts relatively short, about 10 minutes. This makes it easier to apply, but at the same time prevents possible complications, first of all the uncontrolled exit of cement from the vertebral body towards the spinal cord canal and pressure on the nerves inside the canal, but also the entry of liquid cement into the blood vessels.
The cement is very viscous, and with the help of a special hydraulic applicator, it is applied safely and with exceptional control into the body of the vertebra. In this way, the complications of liquid cement were avoided.
Who is vertebroplasty for?
Patients with osteoporotic vertebral fractures, whose pain does not go away even after 3 weeks of conservative treatment (rest with adequate analgesia, possibly wearing an orthosis), are candidates for vertebroplasty. Likewise, patients with metastatic osteolytic changes on the spine, in whom the posterior bony wall of the vertebral body is preserved, are good candidates for vertebroplasty.
Anesthesia, duration and recovery
It is done under local anesthesia, possibly with mild sedation. The procedure lasts about 1 hour, observation after the same for another 3-4 hours, after which the patient is discharged home.
Vertebroplasty is effective in 80-90% of patients. In most cases, pain decreases almost immediately after vertebroplasty, in others within 24-48 hours.
It is recommended to rest in bed for the first 24 hours after the procedure, then gradually return to normal life activities.
Vertebroplasty is minimally invasive and safe procedure in the vast majority of cases. However, complications are possible (less than 3% of patients in total) and include the following: pain at the injection site that usually resolves within a few days after applying local ice and taking analgesics.
Serious complications are extremely rare with viscous cement.