What Should I Expect
Vertebroplasty is an invasive treatment for the relief of back pain that has been caused by the compression or fracture of a vertebral body in either the thoracic or lumbar spine. Vertebroplasty involves placing bone cement into the fractured vertebral body.
How is it Performed?
During the course of the procedure, a person lies on his or her stomach and a needle is placed into the vertebral body of the spine from the back. Real-time x-ray fluoroscopy is used to monitor the placement of the needle into the bony part of the spine. Bone cement mixed with a small amount of inert barium is infused into the vertebral body through the needle. This processed is watched with x-ray throughout the entire procedure. Once a sufficient amount of bone cement has been placed, almost filling the vertebral body, the needle is removed. The person remains on his or her stomach for about twenty minutes while the cement begins to harden. Then, the patient is turned over and lies on his or her back for up to two hours while the cement reaches its ultimate strength.
How should I prepare?
All individuals about to undertake a vertebroplasty should discontinue (under the direction of their primary care physician) any aspirin (one week) and blood thinners (3-5 days) prior to the day of the procedure. On the evening prior to the procedure, you should not eat or drink anything after midnight. Your radiologist will describe the procedure and any potential risks. He will answer any questions you may have about the procedure as well as your expected post-operative recovery.
Once in the x-ray suite, you will be comfortably positioned on your stomach. You will be given pain medication and a mild sedative through your IV until you are comfortable. You will be monitored by the physician and nurse throughout the entire procedure, until you arrive at the recovery room at the conclusion of the procedure. After 1 to 2 hours in the recovery room, you will be discharged with instructions and phone numbers of whom to call for any problems.
Are there potential side effects or complications?
There is a small risk of infection or bleeding with any invasive procedure. Antibiotics will be given to minimize these risks. Furthermore, since the bone cement is introduced into the vertebral body as a liquid, there is the potential for the cement to leak through a fracture. Depending on the location and amount of the leak, one might have no symptoms or a potential worsening of the back pain. Worsening back pain or neurologic symptoms could require surgical correction. By far and away, most leaks are very small and have no adverse symptoms.
What Should I Expect?
Approximately 80% of treated patients have improvement in their symptoms with significant pain reduction within 48 hours. All patients are directed to follow-up with their primary care physician in about two weeks after the vertebroplasty. The radiology staff will usually call in 1 to 2 days to see how you are doing.